PMID- 36299697 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221028 IS - 2296-2360 (Print) IS - 2296-2360 (Electronic) IS - 2296-2360 (Linking) VI - 10 DP - 2022 TI - Type O blood, the MCHC, and the reticulocyte count impact the early recurrence of primary warm-antibody autoimmune hemolytic anemia in children: A retrospective cohort analysis. PG - 881064 LID - 10.3389/fped.2022.881064 [doi] LID - 881064 AB - OBJECTIVE: Primary warm-antibody autoimmune hemolytic anemia (w-AIHA) is prone to recurrence in children. In this study, we aimed to identify risk indicators for the early recurrence of primary w-AIHA and construct an effective recurrence risk assessment model. METHODS: This was a retrospective cohort study. The clinical data of patients hospitalized with primary w-AIHA in the Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, between 1 January 2018 and 30 September 2021, were collected at the initial diagnosis. Univariate and multivariate logistic regression analyses were used to determine risk indicators for the early recurrence of primary w-AIHA in children, and ROC curve and Kaplan-Meier survival analyses were used for verification. Finally, a risk assessment model for early recurrence in children with primary w-AIHA was constructed using Cox regression and visualized using a nomogram. The model was also verified internally and externally. RESULTS: This study included 62 children with primary w-AIHA. Of which, 18 experienced recurrence 1 year after the initial diagnosis. The univariate and multivariate logistic regression analyses showed that type O blood and the reticulocyte count (Ret) were risk indicators for the early recurrence of pediatric primary w-AIHA (P = 0.009, 0.047, respectively). The mean corpuscular hemoglobin concentration (MCHC) is a protective factor (P = 0.040). According to the ROC curve and Kaplan-Meier survival analyses, children with primary w-AIHA whose blood type was O or had an MCHC of <313.5 pg/fL or a Ret of >/=0.161x10(12)/L had a higher risk of early recurrence (HR = 2.640, 4.430 and 4.450, respectively, and P = 0.040, 0.015 and 0.018, respectively). The blood types (O), MCHCs, and Rets of 56 patients were incorporated into the Cox regression model, and the recurrence risk assessment model for children with primary w-AIHA was successfully constructed and visualized using a nomogram. The calibration curves and decision-curve analysis (DCA) suggested that the risk model has clinical applicability and effectiveness. CONCLUSION: Children with type O blood and an MCHC value of <313.5 pg/fL or a Ret value of >/=0.161x10(12)/L have a higher risk of early recurrence. The risk assessment model for the early recurrence of pediatric primary w-AIHA constructed in this study has good clinical applicability and effectiveness. CI - Copyright (c) 2022 Li, An, Xu, Xiao, Wang, Zhu, Huang, Zhang, Yao, Yi, Qin and Yu. FAU - Li, Jiacheng AU - Li J AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - An, Xizhou AU - An X AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Xu, Ximing AU - Xu X AD - Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, Chongqing, China. FAU - Xiao, Li AU - Xiao L AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. AD - Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, Chongqing, China. FAU - Wang, Yang AU - Wang Y AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Zhu, Yao AU - Zhu Y AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Huang, Lan AU - Huang L AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Zhang, Kainan AU - Zhang K AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Yao, Xinyuan AU - Yao X AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Yi, Weijia AU - Yi W AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Qin, Jiebin AU - Qin J AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. FAU - Yu, Jie AU - Yu J AD - Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. LA - eng PT - Journal Article DEP - 20221010 PL - Switzerland TA - Front Pediatr JT - Frontiers in pediatrics JID - 101615492 PMC - PMC9591122 OTO - NOTNLM OT - children OT - primary autoimmune hemolytic anemia OT - recurrence OT - risk indicators OT - warm-antibody COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/10/28 06:00 MHDA- 2022/10/28 06:01 PMCR- 2022/10/10 CRDT- 2022/10/27 02:31 PHST- 2022/02/22 00:00 [received] PHST- 2022/08/10 00:00 [accepted] PHST- 2022/10/27 02:31 [entrez] PHST- 2022/10/28 06:00 [pubmed] PHST- 2022/10/28 06:01 [medline] PHST- 2022/10/10 00:00 [pmc-release] AID - 10.3389/fped.2022.881064 [doi] PST - epublish SO - Front Pediatr. 2022 Oct 10;10:881064. doi: 10.3389/fped.2022.881064. eCollection 2022.