Shah Farrukh, Huey Krystal, Deshpande Sohan, Turner Monica, Chitnis Madhura, Schiller Emma, Yucel Aylin, Moro Bueno Luciana, Oliva Esther Natalie
Department of Haematology, Whittington Health NHS Foundation Trust, London N19 5NF, UK.
Bristol Myers Squibb, Princeton, NJ 08648, USA.
J Clin Med. 2022 Jul 30;11(15):4448. doi: 10.3390/jcm11154448.
Among the difficulties of living with β-thalassemia, patients frequently require blood transfusions and experience iron overload. As serum ferritin (SF) provides an indication of potential iron overload, we conducted a systematic literature review (SLR) to assess whether SF levels are associated with clinical and economic burden and patient-reported outcomes (PROs). The SLR was conducted on 23 April 2020 and followed by analysis of the literature. Dual-screening was performed at the title, abstract, and full-text levels using predefined inclusion and exclusion criteria. Ten studies identified by the SLR were eligible for inclusion in the analysis. Seven studies were conducted in Europe, and most were prospective or retrospective in design. The patient populations had a median age of 20.7-42.6 years, with a percentage of men of 38-80%. Sparse data were found on the correlation between SF levels and mortality, and hepatic, skeletal, and cardiac complications; however, in general, higher SF levels were associated with worsened outcomes. The bulk of the evidence reported on the significant association between higher SF levels and endocrine dysfunction in its many presentations, including a 14-fold increase in the risk of diabetes for patients with persistently elevated SF levels. No studies reporting data on PROs or economic burden were identified by the SLR. SF levels provide another option for prognostic assessment to predict a range of clinical outcomes in patients with β-thalassemia.
在与β地中海贫血共存的困难中，患者经常需要输血并经历铁过载。由于血清铁蛋白（SF）可指示潜在的铁过载，我们进行了一项系统的文献综述（SLR），以评估SF水平是否与临床和经济负担以及患者报告的结局（PRO）相关。该SLR于2020年4月23日进行，随后对文献进行了分析。使用预定义的纳入和排除标准在标题、摘要和全文层面进行双重筛选。SLR确定的10项研究符合纳入分析的条件。7项研究在欧洲进行，大多数研究设计为前瞻性或回顾性。患者群体的中位年龄为20.7 - 42.6岁，男性比例为38% - 80%。关于SF水平与死亡率以及肝脏、骨骼和心脏并发症之间的相关性，数据稀少；然而，总体而言，较高的SF水平与较差的结局相关。大量证据表明，较高的SF水平与其多种表现形式的内分泌功能障碍之间存在显著关联，包括SF水平持续升高的患者患糖尿病的风险增加14倍。SLR未发现报告PRO或经济负担数据的研究。SF水平为预测β地中海贫血患者一系列临床结局的预后评估提供了另一种选择。
