Prevalence of multi-organ complications in patients with non-transfusion and neo-transfusion dependent thalassemia: a cross-sectional survey.

Abstract

This cross-sectional study compared the prevalence of vascular, hepatic, cardiac, endocrine, and bone complications between adult patients with non-transfusion-dependent thalassemia (NTDT) and neo-transfusion-dependent thalassemia (neo-TDT). We evaluated 97 NTDT patients (44.73 ± 12.98 years, 48.5 % females) and 140 neo-TDT (>4 transfusions/year) patients (44.30 ± 12.13 years, 56.4 % females), enrolled in the Extension-Myocardial Iron Overload in Thalassemia project. Iron overload (IO) was assessed by magnetic resonance imaging and complications were defined by established clinical criteria. Neo-TDT patients had significantly higher hemoglobin and ferritin levels and a higher prevalence of hepatitis C virus infection. Hepatic IO was more common in NTDT patients, whereas pancreatic and cardiac IO were significantly more frequent in the neo-TDT group. No significant differences were observed in extramedullary hematopoiesis, leg ulcers, hepatic cirrhosis, thrombosis, or pulmonary hypertension. Cardiac arrhythmias and impaired glucose metabolism were significantly more prevalent among neo-TDT patients. Hypogonadism, hypothyroidism, and hypoparathyroidism were more frequent in neo-TDT patients, though not statistically significant. Bone disorders were the most common in both groups, with a significantly higher prevalence in neo-TDT. In conclusion, neo-TDT patients exhibited a greater burden of cardiac arrhythmias, glucose metabolism disturbances, and bone metabolism disorders, highlighting the need for comprehensive and early multi-organ monitoring and timely intervention strategies.