Assessment of growth retardation among transfusion dependent thalassemia major patients in Peshawar, Pakistan. A Cross Sectional Study

Abstract of Study (Max 300 Words): ABSTRACT

Introduction:

A large population worldwide are affected by thalassemia, which is the most common monogenic hematologic disease and claims thousands of lives annually. Poorly managed transfusion protocol results in iron overload and development retardation in children which is the main complication of this disease.

Objective: The aim of our study is to analyze and assess the association of multiple transfusions with growth retardation particularly in thalassemia children of Peshawar, Pakistan.

Materials & Methods: Cross sectional study on transfusion dependent thalassemia children and adults visiting Fatimid Foundation for treatment was conducted. They were divided into four categories aged 0-5, 5.1 – 10, 10.1 – 15, 15.1 – 20 years for standardized quantitative assessment and measurement of growth patterns for a period of six months.

Results:

A total of 93 thalassemia major children with mean age of 10.86 ± 5.72 years, including 55 (59%) males and 38 (41%) females were analyzed. The mean age of first ever transfusion was reported as 8.13 ± 5.78 months. A low mean BMI 16.38 ± 1.82 was observed in both males 16.24 ± 1.96 and females 16.58 ± 1.59. Merely 14 (15.1%) cases had normal BMI while 79 (84.9%) patients had BMI less than 18. The mean ferritin level in patients was 4179 ± 2811. Only two patients had normal serum ferritin levels.  Also we observed that 66 (71%) children were below 50^th percentile of the growth chart, while 23 (24.7%) children were below 90^th percentile and only 4 (4.3%) children were above 90^th percentile. The sample population was also characterized as patients with normal stature (N = 44) and short stature (N = 49).

Conclusion:  Both male and female thalassemia major patients in the study group had elevated mean ferritin levels. A decrease in BMI and physical abnormalities were reflected by higher serum ferritin levels, which were associated with growth impairment. Early age of first transfusion can determine the incidence of short stature in transfusion dependent thalassemia patients.

Key words: transfusion associated abnormalities, thalassemia major patients, iron overload, growth retardation and Ferritin level