Characterization and risk assessment of HbF elevation in non-thalassemia hematologic disease patients in Guangdong region

This study analyzed clinical data and hematological parameters from 3072 patients undergoing thalassemia screening at Guangdong Provincial People's Hospital, investigating the correlation between non-thalassemic hematologic diseases and elevated fetal hemoglobin (HbF) in Guangdong. Results revealed a significant correlation and identified non-thalassemic hematologic diseases as an independent risk factor for HbF elevation (OR = 13.36, P < 0.001), indicating a substantially higher risk than that of non-hematologic disease patients. Among patients with elevated HbF, significant parameter differences emerged: non-thalassemia hematologic disease patients differed from mild β-thalassemia patients with elevated HbF in mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell distribution width-coefficient of variation (RDW-CV) (P < 0.05); Significant differences in MCV, MCH, RDW-CV, creatinine (CREA), ferritin (Ferr), total bilirubin (TBIL) and direct bilirubin (DBIL) were found between patients with non-thalassemic hematologic diseases and moderate-to-severe β-thalassemia with elevated HbF levels (P < 0.05). Furthermore, significant differences existed between mild and moderate-to-severe β-thalassemia patients with elevated HbF in MCV, MCH, Ferr, TBIL and DBIL (P < 0.05). This research delineates the epidemiological characteristics of hematologic disease-associated HbF elevation in Guangdong, addressing a regional knowledge gap and providing a foundation for clinical risk stratification. Analysis of these differential hematologic indicators deepens understanding of non-thalassemia disease progression, offers clinicians targeted diagnostic and therapeutic strategies, facilitates early detection and intervention, and contributes to broader hematologic research and discipline development.