The Correlation Between Red Blood Cell Lifespan And Clinical And Immune Function In Common Blood Diseases

Objective:To detecte the red blood cell lifespan(RBCS)of patients with newly diagnosed AA、MDS、AML,and to preliminarily explore the correlation between RBCS and clinical and immune function.Meanwhile,the predictive value of RBCS before treatment on the curative effect was analyzed.Methods:We collected the clinical data of 44 patients in 3 groups with AA,MDS and AML newly diagnosed by the second hospital of lanzhou university from March 2019 to March 2020,and 10 healthy volunteers in the same period served as normal controls.The RBCS was detected by CO breath test,flow cytometry was used to measure cellular immune indicators.Then correlation analysis was performed to evaluate the correlation between RBCS and clinical and cellular immune indicators.Receiver operator characteristics(ROC)curve was used to determine a cut-off point to predict effect of RBCS on treatment.Results:The RBCS of patients with AA,MDS and AML was 49.18±21.52 days,35.46±10.29 days,48.00±13.85 days,respectively,which were significantly shorter than that of the normal volunteers(116.20±7.13 days,P<0.05).Further analysis of the correlation between RBCS and clinical and cellular immune indicators indicated that the RBCS of AA patients was negatively correlated with glucose(r=-0.821,P<0.05)and the proportion of B lymphocytes(r=-0.747,P<0.05).The RBCS of MDS patients was positively correlated with hemoglobin concentration(r=0.702,P<0.05);which was negatively correlated with the proportion of CD3~+T lymphocytes(r=-0.584,P<0.05)and CD4~+T lymphocytes(r=-0.494,P<0.05).The RBCS of AML patients was negatively correlated with the proportion of CD4~+T cells(r=-0.461,P<0.05).ROC curve was used to determine a cut-off point to predict effect of RBCS on treatment.The cut-off point of AA was 42d(sensitivity was 87.5%and specificity was 75%).Overall response rate(ORR)in AA patients was no significant difference between RBCS>42d and RBCS≤42d(P=0.242).The cut-off point of MDS was 39.5d(sensitivity was 71.4%and specificity was 83.3%).ORR in MDS patients was no significant difference between RBCS>39.5d and RBCS≤39.5d(P=0.103).The cut-off point of AML was 45d(sensitivity was 84.6%and specificity was 71.4%).ORR were significantly higher in AML patients with RBCS>45d than those≤45d(P=0.022).Conclusion:1.The red blood cell lifespan of newly diagnosed AA,MDS and AML patients was shortened,with the most significant shortening in the MDS group,suggesting that red blood cell damage is present in all three diseases.2.The red blood cell lifespan is correlated with cellular immunity,suggesting that red blood cell lifespan is related to the occurrence and development of diseases.3.The red blood cell lifespan of patients with AML before treatment is related to clinical efficacy,suggesting that red blood cell life is expected to be an indicator to evaluate the efficacy of AML chemotherapy.The exact mechanism mentioned above needs further study.