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β地中海贫血患者的人口统计学、临床特征及真实世界治疗模式:一项回顾性病历摘要研究

Demographics, clinical characteristics, and real-world treatment patterns among patients with beta-thalassemia: a retrospective medical record abstraction study.

作者信息

Cappellini Maria Domenica, Glassberg Mrudula B, Meyers Juliana, Jimenez Maria, Nham Tram, Bueno Luciana, Sieluk Jan, Yucel Aylin, Alashkar Ferras

机构信息

University of Milan, Milan, Italy.

Bristol Myers Squibb, Madison, NJ, USA.

出版信息

Ther Adv Hematol. 2024 Dec 15;15:20406207241298088. doi: 10.1177/20406207241298088. eCollection 2024.

Abstract

BACKGROUND

Beta-thalassemias (BTs) are characterized by deficient or absent synthesis of the beta-globin subunit, leading to anemia. Patient characteristics and treatment patterns in these patients may vary.

OBJECTIVE

This retrospective study evaluated demographics, clinical characteristics, and treatment patterns in patients with transfusion-dependent BT (TDT) and non-transfusion-dependent BT (NTDT).

METHODS

Medical records of adults with TDT or NTDT in the United Kingdom, France, Germany, Spain, and Canada with ⩾5 years of history within the practice were evaluated.

RESULTS

Among patients with TDT ( = 118), mean (standard deviation (SD)) age was 36.1 (11.9) years, and 28.8% were female; among patients with NTDT ( = 96), mean (SD) age was 36.6 (9.8) years, and 38.5% were female. Among patients with TDT, 21.2% received transfusions every 2 weeks or more frequently, 28.8% every 3 weeks, 26.3% every 4 weeks, and 21.2% less frequently than 4 weeks. Patients with TDT had a mean (SD) of 2.4 (0.6) units of blood transfused per transfusion, with a pretransfusion hemoglobin (Hb) level of 6.9 (1.3). In total, 84.4% of patients with NTDT had at least one transfusion, and the mean (SD) number of transfusions among patients with NTDT was 15.9 (15.9). Among patients with NTDT, the mean (SD) units of blood per transfusion were 2.2 (0.6) units, and the mean (SD) Hb level prior to transfusion was 7.4 (1.2) g/dL. Iron chelation therapy was received by 70.3% of TDT patients and 45.8% of NTDT patients.

CONCLUSION

This study found that both patients with NTDT and TDT have low pretransfusion Hb levels. A high number of patients, especially patients with TDT, were not treated according to the current recommendations on target hemoglobin level, thereby highlighting the importance of national reference centers for improving long-term outcomes and quality of life in these patients.

摘要

背景

β地中海贫血(BTs)的特征是β珠蛋白亚基合成不足或缺乏,导致贫血。这些患者的特征和治疗模式可能有所不同。

目的

这项回顾性研究评估了依赖输血的BT(TDT)和非依赖输血的BT(NTDT)患者的人口统计学、临床特征和治疗模式。

方法

对英国、法国、德国、西班牙和加拿大患有TDT或NTDT且在该医疗机构中有≥5年病史的成年患者的病历进行评估。

结果

在TDT患者(n = 118)中,平均(标准差)年龄为36.1(11.9)岁,女性占28.8%;在NTDT患者(n = 96)中,平均(标准差)年龄为36.6(9.8)岁,女性占38.5%。在TDT患者中,21.2%每2周或更频繁地接受输血,28.8%每3周输血一次,26.3%每4周输血一次,21.2%输血频率低于4周一次。TDT患者每次输血的平均(标准差)输血量为2.4(0.6)单位血液,输血前血红蛋白(Hb)水平为6.9(1.3)。总共有84.4%的NTDT患者至少接受过一次输血,NTDT患者的平均(标准差)输血次数为15.9(15.9)次。在NTDT患者中,每次输血的平均(标准差)输血量为2.2(0.6)单位,输血前平均(标准差)Hb水平为7.4(1.2)g/dL。70.3%的TDT患者和45.8%的NTDT患者接受了铁螯合治疗。

结论

本研究发现,NTDT和TDT患者输血前Hb水平均较低。大量患者,尤其是TDT患者,未按照当前关于目标血红蛋白水平的建议进行治疗,从而凸显了国家参考中心对于改善这些患者的长期预后和生活质量的重要性。

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