Correlation of serum ferritin level in transfusion-dependant thalassemia major patients: a study at a medical college affiliated hospital in Gujarat region
Keywords:Ferritin, Thalassemia, Iron chelation
Background: Beta thalassemia is one of the most common causes of inherited disorder in the world. In India, around 65000-70000 cases of thalassemia are present currently and every years around 9000-10000 new cases are added. Measurement of serum ferritin level gives an idea about when to start iron chelation therapy, which will reduce the concentration of iron in the serum and thereby prevents the multiple organ damages.
Methods: A prospective hospital based study was conducted on 100 children having beta thalassemia major. These children were regularly transfused at our hospital and their serum ferritin level were measured by ELISA based assay. Detailed transfusion history and demographic profile were recorded and compared with serum ferritin level. Results were analyzed with SPSS software and Microsoft Excels.
Results: In present study, mean serum ferritin level in 0-5 year age group was1262 µg/l, in 6-10 years age group was 1963.44µg/l and in 11-18 years age group was 2387.43µg/l. On applying ANOVA test, it was evident that there was a statistically significant correlation between increased serum ferritin level with increasing age of the patient as well as with increasing number of a total blood transfusion.
Conclusions: High serum ferritin level in beta thalassemia is associated with increasing age of children as well as with increasing transfusion dependency. Serum ferritin measurement at regular interval helps in determining the ideal timing to start iron chelation therapy in transfusion dependant thalassemic patients.
Verma IC, Choudhary VP, Jain PK. Prevention of thalassemia: a necessity in India. Indian J Pediatr. 1992;59(6):649-54.
Suman RL, Sanadhya A, Meena P, Goyal S. Correlation of liver enzymes with serum ferritin levels in β-thalassemia major. Int J Res Med Sci. 2016;4:3271-4.
Olivieri NF, Brittenham GM. Iron-chelating therapy and the treatment of thalassemia. Blood. 1997;89(3):739-61.
Dleikh FS, Mohsin R, Mousa MJ, Abdul-Amir H. Possible cause-and-effect linkage of transforming growth factor-beta1 and platelets derived growth factor-AB with delayed anthropometric parameters in adolescent patients with Cooley’s anaemia: Cases vs. control research strategy. Eur Asian J Bio Sci. 2020;14:1119-25.
Arab-Zozani M, Kheyrandish S, Rastgar A, Miri-Moghaddam E. A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients. Ann Glob Health. 2021;87(1):48.
Singhal B, Taher AT, Saliba AN. Iron overload in thalassemia: different organs at different rates. Hematology Am Soc Hematol Educ Program. 2017;2017(1):265-71.
BeBaun MR, Frei-Jones M, Vichinsky E. Thalassemia Syndromes. In: Kleigman RM eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:1674-7.
Moiz B, Habib A, Sawani S, Raheem A, Hasan B, Gangwani M. Anthropometric measurements in children having transfusion-dependent beta thalassemia. Hematology. 2018;23(4):248-52.
Telfer PT, Warburton F, Christou S, Hadjigavriel M, Sitarou M, Kolnagou A, Angastiniotis M. Improved survival in thalassemia major patients on switching from desferrioxamine to combined chelation therapy with desferrioxamine and deferiprone. Haematologica. 2009;94(12):1777-8.
Torres FA, Bonduel M, Sciuccati G. Beta thalassemia major in Argentina. Medicina. 2002;62(2):124-34.
Najafipour F. Evaluation of endocrine disorders in patients with thalassemia major. Int J Endocrinol Metab. 2008;2:104-13.
Ikram N, Hassan k, Younas M, Amanat S. Ferritin Levels in Patients of Beta Thalassaemia Major. Int J Pathol. 2004;2(2):71-4.
Choudhry VP, Pati HP, SaxenaA. Deferiprone, efficacy and safety. Indian J Pediatr. 2004;71(3):2136.
Shah N, Mishra A, Chauhan D, Vora C, Shah NR. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India. Asian J Transfus Sci. 2010;4(2):94-8.
Rehman M and Lodhi Y. Prospects and future of conservative management of beta thalassaemia major in a developing country. Pak J Med Sci. 2004;20(2):105-12.
Cunningham MJ, Macklin EA, Neufeld EJ, Cohen AR; Thalassemia Clinical Research Network. Complications of beta-thalassemia major in North America. Blood. 2004;104(1):34-9.
Pemde H, Jagdish Chandra J, Gupta D, Singh V, Sharma R, Dutta AK. Physical growth in children with transfusion- dependent thalassemia. Pediatr Health Med Ther. 2011;2:13-9.