Iron Overload in Transfusion-Dependent Indonesian Thalassemic Patients

Area of Science:

• Hematology
• Cardiology
• Hepatology

Background:

• Thalassemia necessitates regular blood transfusions, leading to iron overload.
• Iron overload causes multi-organ damage, particularly affecting the liver and heart.
• Monitoring organ function is vital in transfusion-dependent thalassemia patients.

Purpose of the Study:

• To evaluate liver and cardiac function in Indonesian transfusion-dependent thalassemia patients.
• To assess the correlation between serum ferritin levels, liver/cardiac function, and T2* MRI findings.
• To identify risks associated with high iron levels in thalassemia.

Main Methods:

• Assessed 66 transfusion-dependent thalassemia outpatients (mean age 21.5 years).
• Conducted blood tests (liver enzymes, serum ferritin), ECG, and echocardiography.
• Utilized T2* MRI for cardiac siderosis assessment in a subgroup.

Main Results:

• Patients with serum ferritin >5000 ng/mL had higher ALT levels and lower TAPSE compared to those with <2500 ng/mL.
• Lower TAPSE was observed in patients with moderate cardiac siderosis on T2* MRI.
• A moderate correlation was found between serum ferritin and cardiac T2* MRI.

Conclusions:

• Elevated serum ferritin levels correlate with liver and cardiac dysfunction in transfusion-dependent thalassemia patients.
• Routine monitoring of iron accumulation complications is essential.
• Early detection and management can mitigate organ damage in thalassemia.