Prevalence of complications in Thalassemia Patients and Outcomes of Treatment in Thalassemia Clinic, Banglamung Hospital, Chonburi

Abstract

Introduction: Thalassemia is the important and common genetic disease in Thailand that has various clinical manifestations and disease-related complications. This study was aimed to report the prevalence of complications and outcomes of treatment in thalassemia clinic, Banglamung hospital.

Method: A retrospective study was conducted in thalassemia patients aged > 18 years old in thalassemia clinic, Banglamung hospital who had followed up regularly at least 6 months. Thalassemia-related complications were pulmonary hypertension, heart failure, extramedullary hematopoiesis, bone fracture, gall stone, endocrine disorder, thrombosis, infection, leg ulcer, transfusion reaction, and alloantibody.  

Result: 51 Thalassemia patients classified into 40 non-transfusion dependent thalassemia (NTDT) and 11 transfusion dependent thalassemia (TDT). All TDT developed iron overload and thalassemia-related complications. In NTDT, 27 patients (67.5%) developed iron overload and 32 patients (92.7%) developed thalassemia-related complications. The most common complications in this study were endocrine disorders (diabetes mellitus, hypothyroidism, sex hormone deficiency, adrenal insufficiency). 43 patients (84%), 33 patients from NTDT and 10 patients from TDT were diagnosed endocrine disorder (P=0.47). Outcomes of thalassemia clinic, we found that hemoglobin level of patients improved from 6.43+1.14 g/dL to 7.13 +1.03 g/dL (P<0.05), monitoring ferritin increased from 45.1% to 100% (P<0.05), ferritin level decreased from 2269.38 +2680.9 ng/mL to 1881.16 + 1599.15 ng/mL (P<0.05), iron overload patients who received iron chelator was increased from 31% to 100% (P<0.05).

Summary: Most common thalassemia-related complications in this study were endocrine disorders, gall stone and pulmonary hypertension, respectively. Establishing thalassemia clinic could improve outcomes of patient care.