Spinal Cord Compression And Extramedullary Hematopoiesis in Young Egyptian β-thalassemia Patients

Abstract

The problem of spinal cord compression (SCC) related to extramedullary hematopoiesis (EMH) in β-thalassemia (β-thal) patients, both clinically and radiologically and its correlation with laboratory parameters of anemia and hemosiderosis was assessed. Sixty β-thal patients were included and divided into group I: 40 β-thal major patients (β-TM), aged 7–30 years with a mean age of 15 ± 5.3 years, group II: 20 β-thal intermedia patients (β-TI) aged 6–20 years with a mean age of 13 ± 4.6 years. They were subjected to neurological examination, thoracic and lumbosacral computed tomography (CT) and magnetic resonance imaging (MRI). Spinal EMH was found in 13.3% of the thalassemic patients with a higher incidence in β-TI compared to β-TM patients (p = 0.03). Evidence of spinal EMH was associated with higher serum ferritin (p < 0.0001), lower pre transfusion hemoglobin (Hb) (p = 0.002) and lower transfusion index (p = 0.01). Extramedullary hematopoiesis was more evident in young β-TI patients, and was related to inadequate chelation, high serum ferritin and inadequate transfusion therapy.

Keywords:

• Spinal cord compression (SCC)
• Extramedullary hematopoiesis (EMH)
• β-Thalassemia (β-thal)
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)

ACKNOWLEDGMENTS

The authors are indebted to Dr. Sahar Ezz El Arab (Medical Doctorat Public Health, Early Cancer Detection Unit-Obstetric and Gynecology Hospital, Ain Shams University, Cairo, Egypt) for her expertise.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.