ABSTRACT
Purpose: Multi-organ hemosiderosis is a known complication in thalassemia patients with chronic blood transfusion. T2-Star (T2*) MRI has been introduced as a non-invasive tool for detecting iron overload in the liver and heart in these patients. This study is to determine and assess renal iron overload by MRI and its relation to liver and heart iron and serum ferritin in Iranian thalassemia patients. Methods: Total 821 transfusion dependent major and intermediate thalassemia patients (age range 10-50 years) were included in this study and calculations were done on their MRI data in a medical imaging center through 2014-2016. Iron values were calculated and averaged in a different region of interests (ROI) using fast-gradient-echo multi-echo T2* sequences. Results: Pathological renal iron content less than 36 ms was around 19.6%. The mean T2* kidney of the total population was 50.26 ms. A moderate negative, statistically significant correlation between kidney T2* relaxation time and serum ferritin was noted. For liver and heart, T2* relaxation time weakly, a statistically significant correlation was acquired by renal T2* relaxation time. Conclusions: Renal hemosiderosis was shown in numerous thalassemia patients. Since the frequency of renal iron deposition was approximately 20% in TM patients in a general population study, it might shed light that frequently monitors the renal iron loading merit hematologists in preventing the secondary side effects.
ABSTRACT
Background: Major Thalassemia is an autosomal recessive disease with complications, mortality and serious pathology. Today, the life expectancy of patients with major thalassemia has increased along with therapeutic advances. Therefore, they need lifelong care, and caring for them would incur many costs. Being aware of the patients' costs can be effective for controlling and managing the costs and providing efficient treatments for the care of patients. Hence, this study was conducted to estimate the economic burden of the patients with major thalassemia
Methods: Totally, 198 patients with major thalassemia were randomly selected from among the patients with major thalassemia in Tehran, Iran in 2015. The economic burden of the patients was estimated from a social perspective and through a bottom-up, prevalence-based approach
Results: The average annual cost per patient was estimated $ 8321.8 regardless of the cost of lost welfare. Of this amount, $ 7286.8 was related to direct medical costs, $ 461.4 to direct non-medical costs, and $ 573.5 to indirect costs. In addition, the annual cost per patient was estimated $ 1360.5 due to the distress caused by the disease
Conclusions: Considering the high costs of the treatment of patients with major thalassemia, adopting new policies to reduce the costs that patients have to pay seems necessary. In addition, making new decisions regarding thalassemia screening, even with higher costs than the usual screening costs, can be useful since the costs of treatment are high
ABSTRACT
Background: Alpha-thalassemia syndrome includes a group of hereditary anemia in which expression of alpha globin chains is decreased or absent. Impaired RBC in patients with thalassemia causes vessel involvement and endothelial cell vessel disturbance. Vascular Endothelial Growth Factor [VEGF] is the most important regulator for endothelial cell proliferation. So, the aim of this study is to compare the serum VEGF levels in patients with alpha thalassemia and normal control group
Materials and Methods: This case-control study was conducted on 17 patients with alpha thalassemia and 40 healthy people. Serum VEGF levels were measured by enzyme-linked immune sorbent assay [ELISA] kit. Then statistical analysis of results were performed using SPSS 16, value of P <0.05 was considered statistically significant
Results: Mean serum VEGF levels in case and control groups were 2294.19 +/- 1552.39 and 598.09 +/- 988.17pg/ml, respectively. Serum VEGF levels were higher in patients with alpha thalassemia [P <0.01]. There was no significant correlation between serum VEGF levels and Hemoglobin. [P= 0.73]
Conclusion: Our study revealed that patients with alpha thalassemia have elevated levels of serum VEGF than normal control group. Further studies with larger sample size are recommended to confirm these observations
ABSTRACT
Improved survival in thalassemic patients has lead to the manifestation of morbidities such as renal dysfunction. This involvement suggests the need for a reliable and non-invasive method to assess the degree of kidney iron overload. We conducted the present study to evaluate the relationship between serum ferritin levels, liver, heart, and kidney MRI gradient echo [T2*] relaxation times in thalassemic patients, as a step to evaluate the feasibility of using MRI T2* to assess the degree of kidney iron overload. This was a prospective study of 120 [60 males, 60 females] regularly transfused thalassemic patients [mean age: 25.9 +/- 9 years] who suffered from major and intermediate thalassemia. Patients attended an adult thalassemia clinic located in Tehran, Iran. Cardiac, hepatic and renal MRI T2* were performed. Serum ferritin levels were measured. Our results indicated a moderate correlation between kidney MRI T2* relaxation time and serum ferritin [r = -0.446, P < 0.001]. Kidney MRI T2* relaxation time weakly correlated with liver MRI T2* relaxation time [r = 0.388, P < 0.001] and cardiac MRI T2* relaxation time [r = 0.338, P = 0.023]. The moderate correlation between kidney MRI T2* relaxation time and serum ferritin, and its weak correlation with liver and heart T2* relaxation times indicate that relying on liver and heart MRI T2*, as well as serum ferritin levels to predict the exact condition of kidney iron overload might not be a reliable approach. Our findings suggest the use of kidney MRI T2* as a noninvasive method for evaluating renal iron overload in thalassemic patients. Further studies to investigate the relation between kidney MRI T2* relaxation times and renal function, as well as the cost benefit of using this method, are suggested