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Prevalence and predictors of cardiac and liver iron overload in patients with thalassemia: A multicenter study based

Rungroj Krittayaphong1, Vip Viprakasit2, Pairash Saiviroonporn3

  • 1Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Blood Cells, Molecules & Diseases
|August 15, 2017
PubMed

Insights

In Thailand, over half of thalassemia patients have liver iron overload, while cardiac iron overload affects a small percentage. Serum ferritin is a key indicator for assessing iron overload in these patients.

Area of Science:

  • Hematology
  • Radiology
  • Public Health

Background:

  • Iron overload is a common complication in thalassemia patients, particularly those receiving regular blood transfusions.
  • The prevalence of cardiac and liver iron overload can differ geographically, even with widespread iron chelation therapy.
  • Understanding real-world management patterns is crucial for optimizing patient care.

Purpose of the Study:

  • To determine the prevalence of cardiac iron overload (CIO) and liver iron overload (LIO) in Thai thalassemia patients.
  • To investigate the management patterns of iron overload in this population.
  • To identify predictors of iron overload using laboratory data.

Main Methods:

  • A multicenter registry was established for thalassemia patients undergoing clinical MRI.
  • Cardiac and liver MRI were performed to assess iron levels in 405 patients.
  • Statistical analysis identified independent predictors for iron overload.

Main Results:

  • The prevalence of CIO was 5.2%, and LIO was 56.8%.
  • Serum ferritin and transaminase levels were independent predictors for both CIO and LIO.
  • Serum ferritin showed potential as a screening tool for CIO and diagnostic tool for LIO.
  • Iron chelation therapy was administered to 74.6% of patients, with 15.3% receiving combination therapy.

Conclusions:

  • Liver iron overload is highly prevalent in Thai thalassemia patients, whereas cardiac iron overload is less common.
  • Serum ferritin is a valuable biomarker for screening and diagnosing iron overload in thalassemia.
  • Current iron chelation therapy use is substantial, but further optimization may be needed.

Keywords:
Blood transfusionIron overloadMagnetic resonance imagingThalassemia

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