Background: Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in β-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in β-thalassemia major patients. Methods: A cross-sectional observation was performed on 102 patients with β-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman’s rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators’ effects between those receiving short-term (≤7 years) and long-term (>7 years) blood transfusion were also analyzed. Results: The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 and p<0.001) and AST ((r=0.569; p<0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups (p=0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group (p=0.001 and 0.022, respectively). Total (p<0.001), indirect (p<0.001), and direct bilirubin levels (p=0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance of p=0.008 in the long-term transfusions group. Conclusions: Ferritin is high in people with transfusion-dependent β-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.

Background: Routine transfusion in β-thalassemia major children will cause excess iron in organs, especially the liver, as illustrated by the serum ferritin value. Excess iron in the liver can cause disturbances in liver enzymes and liver function, which can be assessed using SGOT, SGPT, and albumin examination parameters. This study intends to assess the relationship between increased serum ferritin levels with SGOT, SGPT, and albumin levels in β-thalassemia major children. Methods: This is an observational cross-sectional study which was conducted at the dr. Zainoel Abidin Hospital in Banda Aceh. Research subjects underwent examination of serum ferritin, SGOT, SGPT, and albumin. Results: A total of 37 β-thalassemia major children between 1 until <18 years of age were included in this study. The mean serum ferritin, SGOT, SGPT and albumin levels in β-thalassemia major patients were 4596 ± 2750.07 ng/mL, 57.32 ± 44.20 U/L, 57.46 ± 54.77 U/L, and 4.34 ± 0.22 g/dL respectively. The correlation coefficient between ferritin levels and SGOT was 0.768 (p-value <0.05). While, the correlation coefficient between ferritin and SGPT levels was 0.708 (p-value < 0.05). On the other hand, the correlation value between ferritin and albumin levels was -0.114 (p-value > 0.05). Conclusion: Increased serum ferritin levels in β-thalassemia major children are related to SGOT and SGPT levels. But there is no relationship between increased serum ferritin and albumin levels in β-thalassemia major children.

Thalassemia is a congenital blood disorder characterized by reduced production of one or more globin chains. Thalassemia patients lack healthy hemoglobin which the body needs to be properly oxygenated. Blood transfusion is the main treatment for thalassemia patients. Checking hemoglobin levels after transfusion is a common test, but until now there is no definite uniformity of time to carry out these tests, so it will be detrimental to the patient and increase the length of the patient in the hospital. Assessing the difference in time to increase in hemoglobin levels at 1 hour, 6 hours, and 12 hours after blood transfusion in thalassemia patients. This research is an observational analytic study with cross sectional design. This study was conducted by examining the hemoglobin levels of thalassemia patients after 1 hour, 6 hours, and 12 hours after transfusion in thalassemia patients aged 1-18 years with a total sample of 40 people. The statistical analysis used was paired t test. The results showed that 20 men and 20 women and Most were in the age group 10-13 (35%), with an average Hb level at admission of 7.38 g / dL (95% CI). At 1 hour post-transfusion, the patient's mean Hb level increased by 8.97 g / dL (8,59-9,35 g / dL), at 6 hours post transfusion, 8.95 g / dL (8,57-9,32 g / dL), at 12 hours post transfusion increased by 9.60 g / dL (9,17-10,03 g / dL). Significant increase in Hb levels occurred at 1 hour and 12 hours after blood transfusion.