exudates and Iron-Overload

We explored the severity and risk factors for cardiac and liver iron overload (IOL) in 69 thalassemia patients who underwent T2* magnetic resonance imaging (T2* MRI) in a Malaysian tertiary hospital from 2011 to 2015. Fifty-three patients (76.8%) had transfusion-dependent thalassemia (TDT) and 16 (23.2%) had non transfusion-dependent thalassemia (NTDT). Median serum ferritin prior to T2* MRI was 3848.0 μg/L (TDT) and 3971.0 μg/L (NTDT). Cardiac IOL was present in 16 (30.2%) TDT patients and two (12.5%) NTDT patients, in whom severe cardiac IOL defined as T2* <10 ms affected six (11.3%) TDT patients. Liver IOL was present in 51 (96.2%) TDT and 16 (100%) NTDT patients, 37 (69.8%) TDT and 13 (81.3%) NTDT patients were in the most severe category (>15 mgFe/gm dry weight). Serum ferritin showed a significantly strong negative correlation with liver T2* in both TDT (

Topics: Adult; Blood Transfusion; Early Diagnosis; Female; Ferritins; Humans; Iron Overload; Liver; Magnetic Resonance Imaging; Malaysia; Male; Myocardium; Prevalence; Risk Factors; Sex Factors; Thalassemia

The quality of life of transfusion-dependent thalassaemia patients is affected by the disease itself and iron overload complications from repeated blood transfusion. Desferrioxamine has been used to remove the excess iron, resulting in decreased mortality and morbidity. In Malaysia, a significant proportion of the transfusion-dependent thalassaemia patients are not prescribed desferrioxamine, due to its high cost, especially as it is not subsidized by the government. The aim of this study was to measure the quality of life of thalassaemia patients on desferrioxamine treatment.. A cross-sectional study was performed on all transfusion-dependent thalassaemia patients on follow-up at two tertiary hospitals in Kuala Lumpur, Malaysia, in 2005. Quality-of-life scores were measured by using the translated MOS SF-36 questionnaires, while diseases related to iron overload complications were obtained from the medical records. Use of desferrioxamine was elicited through interviews and validated by drug records. Quality-adjusted life-years (QALYs) presented were formulated from residual life-years and quality-of-life scores.. A total of 112 transfusion-dependent thalassaemia patients were recruited, with 54 (48 percent) and 58 (52 percent) patients on sub-optimum and optimum desferrioxamine treatments, respectively. QALYs were higher in patients on optimum desferrioxamine (9.04, standard deviation [SD] 2.46) than patients on sub-optimum desferrioxamine (5.12, SD 2.51). QALYs were associated with the level of serum ferritin, iron overload complications and total family income.. Optimum desferrioxamine usage reduces iron overload complications and provides a better quality of life.

Topics: Adolescent; Adult; Blood Transfusion; Child; Cross-Sectional Studies; Deferoxamine; Female; Follow-Up Studies; Humans; Iron Overload; Malaysia; Male; Quality of Life; Siderophores; Surveys and Questionnaires; Thalassemia; Treatment Outcome