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Iron overload in non-transfusion-dependent thalassemia: association with genotype and clinical risk factors

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Abstract

In the present study, we sought to determine the prevalence of iron overload in patients with non-transfusion-dependent thalassemia (NTDT) and its association with genotype and other clinical risk factors, and to evaluate the correlation between serum ferritin (SF) and liver iron concentration (LIC). Myocardial and liver iron concentration was measured by MRI using a T2* gradient multi-echo sequence in NTDT patients, aged 10–50 years. Of 91 patients, 54 (59 %) had hepatic iron overload. None had cardiac iron overload. The clinical risk factors for hepatic iron overload were age >20 years (adjusted OR 30.2, 95 % CI 4.5–203, p < 0.001), hemoglobin level <7 g/dL (adjusted OR 6.3, 95 % CI 1.01–39.5, p = 0.049), and cumulative RBC transfusion >10 units (adjusted OR 53.6, 95 % CI 3.2–884, p = 0.005). Beta-thalassemia genotype was associated with higher risk of iron overload by univariate analysis, but the association was not significant when adjusted for other clinical factors. The correlation coefficient between SF and LIC was 0.60 (p < 0.001). In conclusion, the prevalence of hepatic iron overload is high in NTDT. Older age, lower hemoglobin level, and higher cumulative RBC transfusion are significant risk factors. SF and LIC show a significant positive correlation.

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Acknowledgments

This work was supported by Diamond Research Grant, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand (DM 2555). The authors are grateful to Ms Antika Wongthanee, Bio-statistician, for her assistance with statistical analysis, and Ms Suwakon Wongjaikam for her technical assistance.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Adisak Tantiworawit & Sasinee Hantrakool

  2. Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Pimlak Charoenkwan, Worawut Choeyprasert & Torpong Sanguansermsri

  3. Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Chate Sivasomboon

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  1. Adisak Tantiworawit
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  2. Pimlak Charoenkwan
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  3. Sasinee Hantrakool
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  4. Worawut Choeyprasert
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  5. Chate Sivasomboon
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  6. Torpong Sanguansermsri
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Corresponding author

Correspondence to Pimlak Charoenkwan.

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Funding

This work was supported by a Diamond Research Grant, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand (DM 2555).

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The authors report no conflict of interest.

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Tantiworawit, A., Charoenkwan, P., Hantrakool, S. et al. Iron overload in non-transfusion-dependent thalassemia: association with genotype and clinical risk factors. Int J Hematol 103, 643–648 (2016). https://doi.org/10.1007/s12185-016-1991-5

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  • DOI: https://doi.org/10.1007/s12185-016-1991-5

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