Nearly half of patients with beta-thalassemia major suffer from growth impairments, according to research published in the Annals of Global Health. Monitoring these patients’ complications as well as serum ferritin levels may, however, help to mitigate these problems.
Thalassemia is globally the most common inherited disease. Beta-thalassemia major, which is diagnosed in approximately 23,000 infants per year, is frequently treated with both iron chelation and blood transfusion, both of which have improved survival outcomes in this patient population.
There is evidence that frequent blood transfusion may cause hyper iron absorption and iron deposition in the organs. Furthermore, iron overload presents a significant mortality risk among these patients, and may cause hepatic and endocrine issues. Chronic hypoxia leading to anemia in this population is also linked with growth hormone deficiency, growth retardation, bone deformity, and lack of pubertal development.
For this systematic review and meta-analysis, researchers evaluated the rates of growth- and development-related issues in patients with beta-thalassemia major, with the further aim of suggesting novel approaches for disease management in this patient population.
Data from 74 studies were included. All studies took place between 1978 and 2019, and the majority (70.27%) were conducted on the Asian continent, while the fewest (1.35%) were conducted in Oceania; 2.7% were conducted in America. The mean participant age was approximately 14 years.
Overall, the pooled data suggested that 48.9% of included patients were of short stature; this finding was more common in male patients (61.9%) than in female patients (50.9%). Growth retardation occurred in 41.1% of patients, and was similarly more common in male (51.6%) than in female patients (33.1%).
Growth hormone deficiency was present in 26.6% of patients.
“By noticing the control of patients’ serum ferritin levels, [growth hormone deficiency] can be diagnosable,” the authors wrote. “With close monitoring in a proper institute, suitable and acceptable treatment methods besides regular chelation therapy and follow-up, the patients can significantly reduce their complications.”
Arab-Zozani M, Kheyrandish S, Rastgar A, Miri-Moghaddam E. A systematic review and meta-analysis of stature growth complications in β-thalassemia major patients. Ann Glob Health. Published online June 8, 2021. doi:10.5334/aogh.3184