to assess the effect of blood transfusion and chelation therapy on growth and development of transfusion-dependent beta-thalassemia patients in a rural setting of central India

Abstract

Background: Beta-thalassemia major is one of the most severe life-long transfusion-dependent anemias. Clinical features vary from those due to disease itself to those due to consequences of transfusions or chelation therapy, especially affecting the growth and development of these patients. Method: A total 37 patients (aged 2 years to 15 years) were included for this cross sectional study to assess the effect of transfusion and chelation therapy on growth and development of transfusion-dependent beta-thalassemia patients (TDT) in a rural setting of central India. Data and blood reports were collected from January 2019 and was analyzed using SPSS v 22.0 applying non-parametric Man-Whitney U test and Chi Square test for independence of attributes. Findings: Only 5 (13.5%) were adequately transfused maintaining pre-blood transfusion hemoglobin level ≥9gm% and all of them did not have growth retardation. A total 29 patients were under chelation therapy, and 28 (96.55%) were found to have serum ferritin level ≥1000mg/dl. Growth retardation was diagnosed among 17 (45.94%) of the patients, whereas a range of 5-12% of them were having Intelligence Quotient (IQ) or Social Quotient (SQ) <80% as assessed by Seguin form board test, Draw-a-man Test and Vineland Social Maturity Scale. 7 out of 17 patients who were below 6 years of age, were diagnosed as suspects by Denver Developmental Screening tool. Conclusion: A significant number of transfusion-dependent Beta-thalassemia patients were having inadequate transfusion and chelation therapy which affect their growth and development variably (positively corelated if P