Yu Xiaomin, Zhong Mingzhu, Wang Chen, Shi Yifen, Xing Chongyun, Yu Kang, Lin Ying, Ou Rongying, Yang Junjun, Zhu Liqing
Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Med (Lausanne). 2024 Dec 16;11:1463086. doi: 10.3389/fmed.2024.1463086. eCollection 2024.
Peripheral monocytes have been reported to correlate with clinical outcomes in various types of malignancies. Previous reports have also shown that acute-phase thrombotic thrombocytopenic purpura (TTP) plasma could induce the activation of monocytes. However, the significance of peripheral blood absolute monocyte count (AMC) in idiopathic TTP remains an unanswered question. The primary aim of this retrospective study was to evaluate the prognostic value of AMC at admission in idiopathic TTP patients in remission.
A total of 37 patients with idiopathic TTP who survived their first episode of the disease and achieved remission following treatment were eligible for inclusion in the study. SPSS and Stata were used to analysis.
There were 1 patient (2.7%) with low AMC (< 0.12 × 10/L), 27 patients (73.0%) with normal AMC (0.12-0.80 × 10/L), and 9 patients (24.3%) with high AMC (> 0.80 × 10/L) at admission. Ten (27.0%) of 37 patients in our cohort subsequently relapsed (1 in the low AMC group and 9 in the normal AMC group). Survival analysis showed that there was a trend of higher relapse-free survival (RFS) rate in patients having increased A MC (log-rank test, = 0.026). Univariate analysis revealed that increased AMC at admission was significantly associated with higher RFS (hazard ratio = 0.12, 95% confidence interval: 0.02-0.62, = 0.011).
Our results suggest that increased AMC at admission could represent a predictor of higher RFS in TTP patients having survived their first episode of the disease and achieved remission following treatment.
据报道，外周血单核细胞与各类恶性肿瘤的临床结局相关。既往报道还显示，急性期血栓性血小板减少性紫癜（TTP）血浆可诱导单核细胞活化。然而，外周血绝对单核细胞计数（AMC）在特发性TTP中的意义仍未得到解答。这项回顾性研究的主要目的是评估特发性TTP缓解期患者入院时AMC的预后价值。
共有37例特发性TTP患者在首次发病后存活且治疗后达到缓解，符合纳入本研究的条件。使用SPSS和Stata进行分析。
入院时，1例患者（2.7%）AMC较低（<0.12×10⁹/L），27例患者（73.0%）AMC正常（0.12 - 0.80×10⁹/L），9例患者（24.3%）AMC较高（>0.80×10⁹/L）。我们队列中的37例患者中有10例（27.0%）随后复发（低AMC组1例，正常AMC组9例）。生存分析显示，AMC升高的患者无复发生存（RFS）率有升高趋势（对数秩检验，P = 0.026）。单因素分析显示，入院时AMC升高与较高的RFS显著相关（风险比 = 0.12，95%置信区间：0.02 - 0.62，P = 0.011）。
我们的结果表明，入院时AMC升高可能是首次发病后存活且治疗后达到缓解的TTP患者RFS较高的一个预测指标。
