Predictive value of thyroid function in severe aplastic anemia patients treated with immunosuppressive therapy

Autor: Yilin Liu, Jiali Huo, Meili Ge, Xingxin Li, Jinbo Huang, Xiang Ren, Min Wang, Neng Nie, Jing Zhang, Peng Jin, Yingqi Shao, Yizhou Zheng
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Blood Science, Vol 6, Iss 2, p e00182 (2024)
Druh dokumentu: article
ISSN: 2543-6368
00000000
DOI: 10.1097/BS9.0000000000000182
Popis: To explore the predictive value of thyroid function in severe aplastic anemia (SAA) patients treated with immunosuppressive therapy (IST), 149 SAA patients in our center were enrolled between February 2015 and June 2020 in this study. We assessed the thyroid function of 134 patients without primary thyroid diseases, and discovered that 89 patients were accompanied by abnormal thyroid hormone, especially low triiodothyronine (T3). Patients with higher pretreatment-free T3 (FT3) levels (>5 pmol/L) demonstrated superior response rates at 3 and 6 months after IST compared to those with lower FT3 levels (54.5% vs 35.4%, P = .020; 67.3% vs 46.9%, P = .020). Multivariate analysis indicated that shorter disease duration (≤56 days) and response at 6 months were independent favorable factors of overall survival (relative risk [RR] = 2.66, 95% confidence interval [CI] = 1.03–6.90, P = .040; RR = 30.10, 95% CI = 4.02–225.66, P = .001). The 6-year failure-free survival (FFS) was 53.8% (95% CI = 40.9%–65.1%). Multivariate analysis revealed that patients with a response at 6 months, shorter duration (≤56 days) and receiving rabbit antithymocyte globulin (ATG) had better FFS outcomes than those without a response at 6 months, with a longer duration and receiving porcine ATG (RR = 22.6, 95% CI = 7.9–64.9, P < .001; RR = 2.4, 95% CI = 1.3–4.5, P = .006; RR = 2.5, 95% CI = 1.1–5.8, P = .030). In conclusion, FT3 levels reflect the severity of SAA, and patients with higher FT3 levels (>5 pmol/L) had superior response rates than those with lower ones.
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