Pretransfusion Hemoglobin Level and Pattern of Iron Chelation of the Transfusion Dependent Thalassemia Patients

Background: Thalassemia is a common hereditary blood disorder in Bangladesh, requiring regular blood transfusions and iron chelation therapy to manage its complications and improve life quality. Objective: The study aimed to evaluate the pretransfusion hemoglobin levels, the pattern of iron chelation therapy, and the associated complications in transfusion-dependent thalassemia patients. Methods: This hospital-based cross-sectional descriptive study was conducted over six months (November 2016 to April 2017) at Rajshahi Medical College Hospital, with 75 transfusion-dependent thalassemia patients. Data were collected through structured questionnaires from patients' parents, and statistical analysis was performed using SPSS (version 16) to assess means, standard deviations, and p-values. Results: The average age of the patients was 7.7±2.3 years, with 57.33% in the 5-10 years age group. The first blood transfusion occurred at 2.5 years. The mean number of blood transfusions was 52.48±23.90 units. Serum ferritin levels were elevated (mean 3638.74±2567.79 ng/ml), and pretransfusion hemoglobin was low (7.2±1.56 gm/dl). Only 9.33% received regular chelation therapy, and 74.67% did not use any form of chelation. Statistical analysis revealed that patients with facial dysmorphism had significantly lower hemoglobin (6.32 gm/dl, p=0.03) and higher serum ferritin (4774.46 ng/ml in stunted patients). Patients with >50 transfusions had a higher serum ferritin level. Additionally, a longer duration of chelation therapy showed a lower serum ferritin level. Conclusion: This study indicates that thalassemia patients often receive transfusions irregularly and exhibit delayed chelation therapy initiation. Most patients fail to adhere to regular chelation despite elevated serum ferritin levels.