Can immature granulocyte count be a practical marker for evaluating bone marrow activation in beta thalassemia patients?

Abstract

Aim: In our study, we aimed to investigate whether the immature granulocyte and immature granulocyte percentages of our pediatric and adult beta thalassemia major and intermedia patients could be used as a practical marker in evaluating bone marrow activation. Method: Between January 2017 and December 2021, 38 Beta thalassemia major and 12 Beta thalassemia intermedia patients who applied to Mersin University Faculty of Medicine Pediatric and Adult Hematology Department were included in the study, hemoglobin (gr/dl), hematocrit, white blood cell count (x103/µL), platelet count (x103/µL), immature granulocyte count (x103/µL), immature granulocyte percentage, ferritin (ng/mL), chelation status, transfusion frequency and order, mean hemoglobin level in the last year were recorded. Patients who received and did not receive regular transfusion were compared in terms of immature granulocyte and other parameters. Results: When the patients were grouped as children and adults; mean hemoglobin levels in the last year were higher in children but white blood cell, immature granulocyte and platelet counts were significantly higher in adults (p<0.05). It was seen that those who received regular transfusion were mostly pediatric patients. The mean hemoglobin level in the last year was significantly lower in those who received irregular transfusion, but immature granulocyte level, platelet and white blood cell count were higher (p<0.05). It was observed that as the mean hemoglobin levels in the last year increased, the mean immature granulocyte count and immature granulocyte percentage decreased. Conclusion: In our study, immature granulocyte count and percentage, white blood cell and platelet count were found to be statistically significantly higher in patients with irregular transfusion and the increase in immature granulocyte and percentage parameters of immature granulocyte as the mean hemoglobin level in the last year decreased, suggesting that hematopoiesis in the bone marrow is active in these patients. We think that immature granulocyte and immature granulocyte percentage parameters, which can be measured in almost every center, can be used to evaluate the degree of inflammatory activity and transfusion efficiency in patients with beta thalassemia.