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Eighty multi-transfused beta-thalassemics--40 of them on regular transfusion (RT) (every 3-4 weeks) and 40 irregularly transfused (IT)-and 20 age- and-sex-matched controls were evaluated for serum erythropoietin (sEpo) and soluble serum transferrin receptors (sTfr) as indicators of erythropoietic activity. All subjects were studied for pre-transfusion hemoglobin (Hb), reticulocytic index (RI), serum ferritin, sEpo and sTfr. Results showed that the mean RI, sEpo and sTfr values were significantly higher in the IT group (2.8; 80 mU/ml; and 19 microg/ml, respectively) compared to the RT group (1.2; 35.2 mU/ml; and 13.9 microg/ml, respectively) and controls (1.1; 22.6 mU/ml; and 7 microg/ml, respectively) (p &lt; 0.05); while only the mean sTfr value was significantly higher in the RT group compared to controls. The mean pre-transfusion Hb was significantly lower in the IT group (8 g/dl) compared to both the RT group (9.3 g/dl) and controls (12.5 g/dl) (p &lt; 0.05); while the RT group level was significantly lower than controls. There was an inverse correlation between Hb level on one hand and sEpo (r = 0.324,p &lt; 0.05), sTfr (r = -0.651, p &lt; 0.05) and RI (r = -0.451, p &lt; 0.05) on the other. In summary, sEpo, sTfr and RI could be used as accurate and reliable indicators of successful erythroid marrow suppression and for the determination of optimal pre-transfusion Hb level in thalassemia on an individual basis, with sTfr being the most sensitive indicator.

journal of tropical pediatrics

Evaluation of Serum Soluble Transferrin Receptors and Erythropoietin Levels as Indicators for Erythropoietic Activity Among Multi-transfused -thalassemic Patients