The Impact of Iron Overload in Transfusion-Dependent Beta Thalassemia Major Patients in Peshawar

Iron Overload in Beta Thalassemia Major

Abstract

Background: Patients experiencing transfusion as a result of thalassemia are highly prone to various clinical complications that are influenced by age and inherited characteristics such as consanguinity. Objective: The purpose of the research was to determine demographic factors, family history, and clinical outcomes of 293 Pakistan-based patients with TDT. Study Design: Cross-sectional study. Settings: Hayatabad Medical Complex, Peshawar, Pakistan. Duration: Six months from July to December 2023. Methods: Information about age, gender, consanguinity, family history, number of blood transfusions received per month, iron overload, and medication status and chelation therapy treatment were recorded. Descriptive statistics, chi square tests and binary logistic regression were conducted. Odds ratios (ORs) were adjusted, and presented with 95% confidence intervals (CIs), where p is < 0.05. Results: The mean age was 11.78 ± 6.29 years (range: 2–34), and 58.7% were male. The largest age group was 6–10 years (36.2%). 69.6% were consanguineous and 51.9% had a positive family history. 59.4% of patients had iron overload. The mean transfusion burden was 1.82 ± 0.83 units/month. The frequency of blood transfusion had significantly high association with iron overload (χ² = 19.892, df = 3, p < 0.001). A univariable logistic regression revealed that for each additional transfused unit/month, the odds of iron overload rose by 1.624 (95% CI: 1.134 – 2.325; p = 0.008). Proper medication was associated with lower odds (OR = 0.141, 95% CI: 0.042–0.476, p = 0.002), while absence of chelation therapy was strongly associated with iron overload (OR = 45.541, 95% CI: 10.007–207.251, p < 0.001). Conclusion: Iron overload was highly prevalent in the subject population and presents an independent risk factor for transfusion burden and chelation therapy.