RELATIONSHIP BETWEEN BLOOD TRANSFUSION FREQUENCY AND BLOOD IRON CONCENTRATION IN PATIENT WITH THALASSEMIA MAJOR
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Keywords:
frequency, blood transfusion, ferritin level, thalassemia major, childrenAbstract
Routine blood transfusions performed on thalassemia major patients can cause excessive iron accumulation in the body, which carries the risk of complications. Serum ferritin levels are used to assess body iron stores. This study aims to determine the correlation between transfusion frequency and iron accumulation in patients with thalassemia major. This study used a cross-sectional design with analytical observation. Data was collected by consecutive, non-random sampling from the medical records of 55 patients with thalassemia major aged 5-18 years who underwent blood transfusions at Hermina Jatinegara Hospital from January to December 2023. The independent variable was the frequency of blood transfusions per year, while the dependent variable was the average serum ferritin level, measured three times a year (every 4 months). The data obtained were analyzed using the Spearman correlation test. The results of this study found that the frequency of blood transfusions in thalassemia major patients over 1 year was 15 per year (based on the median). The average serum ferritin level was 3957.73 ng/mL (based on the median value). Spearman's correlation test showed a weak correlation between blood transfusion frequency and ferritin levels (r = 0.292; p = 0.031). The study concluded that increased blood transfusion frequency was associated with higher blood iron levels, but the correlation was weak.
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Author Biography
Vanessa Ainum Rizqita, Undergraduate Medical Study Program, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
Undergraduate Medical Study Program, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
References
1. Wahidiyat P, Permono B. Hemoglobinopati dan thalassemia anak. In: Permono B, Sutaryo I, Ugrasena ID, Windastuti E, Abdulsalam M, editors. Buku ajar hematologi-onkologi anak. Jakarta: Ikatan Dokter Anak Indonesia; 2018:65-8.
2. Grentina, Wahidayat PA. Mengenal thalassemia [Internet]. Jakarta: Ikatan Dokter Anak Indonesia; 2016 [cited 2024 Apr 7]. Available from: https://www.idai.or.id/artikel/seputar-kesehatan-anak/mengenal-thalasemia
3. Rujito L, Siswandari W, Lestari DW, editors. Talasemia: genetik dasar dan pengelolaan terkini. Purwokerto: UNSOED Press; 2019:90.
4. Khikmah FA, Prijopranoto HS. Prevalensi thalasemia beta minor dengan menggunakan indeks mentzer pada pasien anemia Suku Sabu di RSUD Sabu Raijua. Journal of Ners Community. 2022;13(2):301-6. doi:10.55129/jnerscommunity.v13i2.1917
5. World Health Organization. Regional desk review of haemoglobinopathies with an emphasis on thalassaemia and accessibility and availability of safe blood and blood products as per these patients’ requirement in South-East Asia under universal health coverage [Internet]. 2023 [cited 2024 Apr 30]. Available from: https://www.who.int/publications/i/item/9789290228516
6. Fianza PI, Rahmawati A, Widihastha SH, Afifah S, Ghozali M, Indrajaya A. Iron overload in transfusion-dependent Indonesian thalassemic patients. Anemia. 2021:5581831. doi:10.1155/2021/5581831
7. Rochman F, Mulyantari NK, Sutirtayasa IW. Hubungan jumlah transfusi darah dan penggunaan kelasi besi dengan kadar ferritin pada pasien talasemia. Medika Udayana. 2019;8(9):1-6
8. Lal A, Wong T, Keel S, Pagano M, Chung J, Kamdar A. The transfusion management of beta thalassemia in the United States. Transfusion. 2021;61(10):3027-39. doi:10.1111/trf.16640
9. Taher AT, Cappellini MD. How I manage transfusional iron overload in patients with thalassemia. Blood. 2021;137(6):667-75
10. Bhalodiya VR, Valiya LG, Mehta NA, Padhariya BB. Correlation of serum ferritin level in transfusion-dependant thalassemia major patients: a study at a medical college affiliated hospital in Gujarat region. Int J Contemp Pediatr. 2023;10(3):330-3. doi:10.18203/2349-3291.ijcp20230429
11. Pangestika AD, Astuti TD, Aryani T. Literature review: gambaran kadar hemoglobin dan ferritin serum pada anak thalassemia β mayor paska transfusi [Internet]. 2022 [cited 2024 Mar 15]. Available from: http://digilib.unisayogya.ac.id/6629/1/NASKAH%20PUBLIKASI_AYU%20DWI%20PANGESTIKA_1811304020%20-%20Ayu%20Dwi%20Pangestika
12. Yusuf AK, Magdaleni AR, Karunia D. Hubungan kadar feritin serum terhadap fraksi ejeksi ventrikel kiri pada pasien thalassemia β mayor anak di RSDU Kabupaten Kediri. Jurnal Verdure. 2022;4(1):123–8.
13. University of Rochester Medical Center. Ferritin (Blood) [Internet]. URMC Health Encyclopedia; 2023 [cited 2026 Feb 24]. Available from: https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=167&contentid=ferritin_blood
14. Fianza PI, Rahmawati A, Wijaya I, Oehadian A, Prasetya D, Vidyaniati P. Gender disparities in psychological disturbances and quality of life among adolescent and adult patients with thalassemia: a review. J Multidiscip Healthc. 2024;17:1663-9. doi:10.2147/jmdh.s444592
15. Sadiq IZ, Abubakar FS, Usman HS, Abdullahi AD, Ibrahim B, Kastayal BS. Thalassemia: pathophysiology, diagnosis, and advances in treatment. Thalass Rep. 2024;14(4):81-102. doi:10.3390/thalassrep14040010
16. Almahmoud R, Hussein A, Khaja FA, Soliman AF, Dewedar H, Shareef ZA. Growth and endocrinopathies among children with β-thalassemia major treated at Dubai Thalassemia centre. BMC Pediatr. 2024;24:244. doi:10.1186/s12887-024-04670-w
17. Nassim MS, Mahmoud MA, Shady HA, Mohammed EAER. Assessment of disease knowledge gaps among beta thalassemia major patients and their caregivers. Egypt Pediatr Assoc Gaz. 2022;70:49. doi:10.1186/s43054-022-00143-w
18. Akbar TIS, Riyanti EY, Khairunnisa K, Wahyuni H. No association between frequency of blood transfusions and incompatibility of blood transfusions in thalassemia patients. J Indones Med Assoc. 2023;73(4):183-90. doi:10.47830/jinma-vol.73.4-2023-1069
19. Saparizki RS, Sumantri AF, Achmad S. Pengaruh kepatuhan minum obat kelasi besi dengan kadar ferritin pada pasien thalassemia di RSUD Al-Ihsan Bandung tahun 2021/2022. Bandung Conference Series: Medical Science. 2023;3(1):178-9. doi:10.29313/bcsms.v3i1.5824
20. Kurban LA, Almarri BK, Alshamsi MH, Abdelrahman SS, Alwahshi SG, Alhorani Q. Optimized serum ferritin prediction of iron overload in transfusion-dependent thalassemia: likelihood ratio and age-adjustment approach. Ann Saudi Med. 2023;43(2):90-6. doi:10.5144/0256-4947.2023.90
21. Sarkar K, Pramanik N, Goswami RP, Mandal PK, Chowdhury P, Jana K. Correlation of liver function test with different age and sex group and with ferritin level in thalassemia. Indian J Public Health Res Dev. 2020;11(6):452-7. doi:10.37506/ijphrd.v11i6.9819
22. Weiss M, Parisi Jun M, Sheth S. Clinical and economic burden of regularly transfused adult patients with β-thalassemia in the United States: a retrospective cohort study using payer claims. Am J Hematol. 2019;94(5):E129-32. doi:10.1002/ajh.25429
23. Shah F, Huey K, Deshpande S, Turner M, Chitnis M, Schiller E. Relationship between serum ferritin and outcomes in β-thalassemia: a systematic literature review. J Clin Med. 2022;11(15):4448. doi:10.3390/jcm11154448
24. Coates TD. Iron overload in transfusion-dependent patients. Hematology Am Soc Hematol Educ Program. 2019;2019(1):337-44. doi:10.1182/hematology.2019000036
25. Spasiano A, Meloni A, Costantini S, Quaia E, Cademartiti F, Cinque P. Setting for "normal" serum ferritin levels in patients with transfusion-dependent thalassemia: our current strategy. J Clin Med. 2021;10(24):5985. doi:10.3390/jcm10245985
26. Mohamed YA, Morgan DS, Hussein AM, Mohamed AA. Noninvasive assessment and risk factors of liver fibrosis in pediatric patients with beta thalassemia major using transient elastography. Beni Suef Univ J Basic Appl Sci. 2022;11:114. doi:10.1186/s43088-022-00314-z
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