Assessment of serum soluble transferrin receptor in adult Egyptian aplastic anemia patients.

Aplastic Anemia (AA) is one of the life-threatening bone marrow failure syndromes. One of the main pathologies of AA is reduced erythropoietic activity evidenced by decreased soluble transferrin receptor (sTfR) levels which results in minimal iron utilization and accumulation of iron in tissues in the form of ferritin. This study aimed to measure serum level of sTfR in adult AA patients and correlate it with the severity of the disease and the response to treatment. The study included 35 randomly selected AA patients recruited from the Hematology Department, aged from 17 to 66 years and 27 normal controls of matched age and sex. The level of sTfR was measured by using an enzyme linked immunoassay. The median level of sTfR was significantly lower in AA cases than in controls (17.9 nmol/l, ranged 9.87-30.42 nmol/l vs. 52.2 nmol/l; ranged 29.74-86.84 nmol/l, (p < 0.001). The concentration of sTfR was significantly lower in the Very Severe Aplastic Anemia (VSAA) patients in comparison to Severe Aplastic Anemia (SAA) 34.27 nmol/l (ranged 31.05 - 45.41 nmol/l) vs. 55.15 nmol/l (ranged 48.78-63.88 nmol/l), respectively, p= 0.004). The level of sTfR in responders to immunosuppressive treatment did not show any difference in comparison to non-responders [55.15 nmol/l (ranged 47.36 - 65.35 nmol/l) vs. 48.26 nmol/l (ranged 34.62 - 60.39 nmol/l), (p=0.808). In conclusion, sTfR level was significantly lower in AA cases than controls. The sTfR concentration expresses the erythropoietic activity in AA patients and can be an indicator of severity of bone marrow failure.