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Effect of splenectomy on iron balance in patients with β‐thalassemia major: a long‐term follow‐up
Author(s) -
Casale Maddalena,
Cinque Patrizia,
Ricchi Paolo,
Costantini Silvia,
Spasiano Anna,
Prossomariti Luciano,
Minelli Salvatore,
Frega Valeria,
Filosa Aldo
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12121
Subject(s) - splenectomy , thalassemia , medicine , term (time) , balance (ability) , pediatrics , spleen , physical therapy , physics , quantum mechanics
Objective A retrospective study was performed to explore the effect of splenectomy on iron balance in thalassemia major ( TM ). Methods Twenty two TM patients treated with splenectomy were compared with a control group (non‐splenectomized patients) matched for sex, age, pretransfusional Hb, chelation therapy, and duration of follow‐up in a retrospective study to evaluate blood consumption, iron intake, and serum ferritin during an overall observation period of 6 yrs before and 10 yrs after splenectomy. Results Splenectomy improved parameters of iron balance, determining a significant reduction in blood consumption ( P < 0.01), iron intake ( P < 0.01), and serum ferritin ( P < 0.01). Comparing the two groups, blood consumption and iron intake were similar in presplenectomy period ( P > 0.05), but serum ferritin was significantly higher in splenectomized patients ( P < 0.01). After splenectomy, blood consumption and iron intake were significantly lower ( P < 0.01) in splenectomized group while serum ferritin did not differ significantly ( P > 0.05) between two groups, except for the first year ( P < 0.05). Conclusion Splenectomy determines immediate drop in blood consumption and iron intake but slow downtrend of ferritin; direct measurements of iron overload, such as magnetic resonance studies, are needed to better understand the effect of splenectomy on iron balance parameters. Tailoring chelation therapy and eventually its intensification seem more efficient measures to manage iron accumulation in TM and to lower iron level to safety threshold.