Clinical Characteristics of Thalassemia in Children: A Comparison of Pre-Transfusion Hemoglobin Levels in Buri Ram, Thailand

Abstract

Background: Blood transfusion is the primary treatment in transfusion-dependent thalassemia (TDT). Maintaining an appropriate pre-transfusion hemoglobin level is crucial for promoting growth and reducing complications.
Objectives: To compare the clinical characteristics between pediatric thalassemia patients who achieve and non-achieve target pre-transfusion hemoglobin levels
Methods: A retrospective descriptive study was conducted on transfusion-dependent thalassemia patients aged 0-18 years at Buriram Hospital from January 1^st., 2021, to December 31^st., 2022. The average of 10 pre-transfusion hemoglobin values was used to analyze and compare clinical characteristics between the groups that met the target hemoglobin level and those that did not.
Results: A total of 61 eligible patients were included. The majority had B0-thal/Hb E disease (65.6%), with a mean age of 9.15 (± 3.91) years, and were predominantly male (55.7%). Although 75.4% of patients were transfused every 3-4 weeks, only 8 individuals (13.1%) consistently achieved the recommended pre-transfusion hemoglobin target level. Comparative analysis revealed a statistically significant difference in the mean pre-transfusion hemoglobin level (p = 0.000) between the target-achieving group (9.3 ± 0.3 g/dL) and the non-target group (8.3 ± 0.8 g/dL). No statistically significant differences were found in any other clinical outcomes such as growth, facial changes, or splenic size (p > 0.05). However, it was clinically noted that the target-achieving group consistently demonstrated better clinical characteristics.
Conclusions: Achieving the target pre-transfusion hemoglobin level was statistically associated with significantly higher pre-transfusion hemoglobin levels. Furthermore, patients in this group demonstrated better clinical characteristics across various domains, including growth, facial changes, and splenic size.