The association between pre-transfusion hemoglobin levels and thalassemia complications

Abstract

Objectives: To evaluate any association between pre-transfusion hemoglobin (Hb) levels and thalassemia complications and to identify the Hb cutoff values to predict thalassemia complications. Methods: We performed a cross-sectional study in thalassemia patients who attended the Adult Hematology Clinic of the tertiary care University Hospital from October 2017 to October 2018. A point-biserial correlation was used to identify any association between Hb levels and thalassemia complications. A receiver operating characteristic (ROC) curve was used to identify the diagnostic ability of Hb levels to predict thalassemia complications and identify Hb cutoff values. Results: Out of the 102 patients, there were 53 transfusion dependent thalassemia (TDT) patients and 49 non-transfusion dependent thalassemia (NTDT) patients. In theTDT group, Hb levels showed a negative correlation with severe hepatic iron overload and hypogonadism. The cutoff Hb levels to predict severe hepatic iron overload and hypogonadism were ≤7.01 and 6.81 g/dL, respectively, at which points the area under the ROC curve (AUC) were 0.721 and 0.708, respectively. In the NTDTgroup, Hb levels were negatively correlated with hepatic iron overload, osteoporosis, and pulmonary hypertension. The cutoff values of Hb levels to predict hepatic iron overload, osteoporosis, and pulmonary hypertension were ≤8.24, 7.16, and 7.16 g/dL, respectively, at which points the AUC were 0.923, 0.715, and 0.725, respectively. Conclusions: Lower Hb level was associated with more frequent complications in both TDT and NTDT patients. The Hb cutoff levels to predict these complications were identified.

Real‐world complication burden and disease management paradigms in transfusion‐related β‐thalassaemia in Greece: Results from ULYSSES, an epidemiological, multicentre, retrospective cross‐sectional study

“…The complications recorded in ULYSSES are those most encountered among transfusion-dependent thalassaemia patients [32]. The most represented complications affecting at least one-third of the patients in ULYSSES were endocrine disorders/metabolic/nutrition disorders (such as osteoporosis; 56.2%), surgical/medical procedures and blood/lymphatic system disorders (such as hypersplenism; 33.8%), which were within the ranges recorded in other studies [8,15,[32][33][34][35][36][37].…”

Blood Transfusion Complications and Associated Factors Among Blood-Transfused Adult Patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A Cross Sectional Study

“…Studies indicate a negative correlation between pre-transfusion Hb and transfusion complications in Thailand. 42 Patients’ low pre-transfusion hematocrit and the dose of PRBCs administered were risk factors, but not factors in survival. 39 , 43 …”

Comparison of post-decompressive haematuria in rapid versus gradual bladder decompression in patients with chronic urinary retention

“…Complications of blood transfusion could be early, which ranges from mild febrile non-haemolytic reaction to severe graft versus host disease and ultimately death or late complications, which includes bloodborne diseases, such as viral, fungal, or bacteria microorganisms:[ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] even in a screened blood, especially when the donor is in the window period. Since every patient transfused is at risk of these complications, every surgeon aims to employ every medical option not to transfuse or reduce the rate of blood transfusion in surgical patients to avoid or minimise transfusion-related complications.…”