The association between pre-transfusion hemoglobin levels and thalassemia complications

Figures & data

Table 1. Demographic and clinical characteristics of the study patients.

Patient characteristics	All patients (N = 102)
Sex
Male (%)	36 (35.3)
Female (%)	66 (64.7)
Mean age (years) (mean ± SD)	32.1 ± 9.0
Presence of co-morbidities (%)	25 (24.5)
Thalassemia type n (%)
Βeta-thalassemia
Beta-thalassemia/HbE disease	65 (63.7)
Homozygous beta-thalassemia	17 (16.7)
Alpha-thalassemia
Hb H disease	10 (9.8)
Hb H/constant spring disease	7 (6.9)
Hb H with Hb E trait	3 (2.9)
Transfusion status
TDT (%)	53 (52.0)
NTDT (%)	49 (48.0)
Previous splenectomy (%)	58 (56.9)
Iron chelators
None (%)	19 (18.6)
Deferiprone (%)	40 (39.2)
Deferoxamine (%)	3 (2.9)
Deferasirox (%)	6 (5.9)
Combination (%)	34 (33.4)
Mean pre-transfusion Hb (g/dL) (means ± SD)	7.3 ± 1.1

Table 2. Prevalence of thalassemia complications.

Thalassemia complications	All patients (N = 102) n (%)	TDT patients (n = 53) n (%)	NTDT patients (n = 49) n (%)	P value
Iron overload characterized by serum ferritin	70 (69.3)	47 (88.7)	23 (47.9)	< 0.001
Hepatic iron overload	83 (81.4)	47 (88.7)	36 (73.5)	0.049
Cardiac iron overload	4 (3.9)	4 (7.5)	0 (0)	0.119
Hypothyroidism	13 (12.7)	11 (20.8)	2 (4.1)	0.016
Hypogonadism	12 (11.8)	12 (22.6)	0 (0)	< 0.001
Adrenal insufficiency	3 (2.9)	2 (3.8)	1 (2)	1.000
Diabetes mellitus	7 (6.9)	6 (11.3)	1 (2)	0.114
Cholelithiasis	36 (35.3)	17 (32.1)	19 (38.8)	0.479
Cirrhosis	3 (2.9)	0 (0)	3 (6.1)	0.107
HCC	1 (1.0)	0 (0)	1 (2)	0.480
Pulmonary hypertension	12 (11.8)	3 (5.7)	9 (18.4)	0.047
Cardiomyopathy	1 (1.0)	1 (1.9)	0 (0)	1.000
Thrombosis	4 (3.9)	3 (5.7)	1 (2)	0.619
Bone mineral density (BMD)^b
Osteopenia	34 (33.3)	18 (37.5)	16 (53.3)	0.170
Osteoporosis	41 (40.2)	28 (58.3)	13 (43.3)	0.197
EMH	25 (24.5)	14 (26.4)	11 (22.4)	0.642
Leg ulceration	2 (1.9)	1 (1.9)	1 (2)	1.000
Overall complications^c	92 (90.2)	53 (100)	39 (79.6)

^aMissing data in cases of NTDT = 1.

^b Missing data in cases of TDT = 5, NTDT = 19.

^c Excluding osteopenia and iron overload characterized by serum ferritin level.

Figure 1. The scatter plot between Hb levels and complications (A) severe hepatic iron overload (B) hypogonadism in TDT patients.

Figure 2. The scatter plot between Hb levels and complications (A) hepatic iron overload (B) osteoporosis (C) pulmonary hypertension in NTDT patients.

Figure 3. ROC curve for predicting (A) severe hepatic iron overload (B) hypogonadism in TDT patients based on pre-transfusion Hb levels.

Figure 4. ROC curve for predicting (A) hepatic iron overload (B) osteoporosis (C) pulmonary hypertension in NTDT patients based on pre-transfusion Hb levels.