A study on growth profiles in children with thalassemia major between 2-10 years of age on regular transfusions and oral chelation therapy

Simhachalam Malluvalasa, Manasranjan Sahoo, Uma maheswrararao Kuppili

Abstract


Introduction: Thalassemia patients require regular blood transfusions to maintain haemoglobin level around 10gm/dl, which results in transfusional iron over load which is treated by well-established parenteral desferrioxamine or oral chelators. There are conflicting reports on effectiveness of oral chelators. Only few studies are available on the growth parameters of thalassemic children from this region. The present study was undertaken to assess the growth pattern and its relation with Mean Pre-transfusion Haemoglobin value and Serum ferritin concentration in study population. Materials and Methods: The present study was done at Thalassemia and Sickle CellSociety, Hyderabad. The study group includes Transfusion dependent thalassemia major children on oral Iron Chelation Therapy between 2-10 years of age. Specific inclusion and exclusion criteria were framed and subjects fulfilling the criteria were selected for the study. Anthropometry of the children was measured and necessary data from the medical records of the children was reviewed during the study period  September 2012 to May 2013. Results: In Mean pre transfusion haemoglobin <8 g/dl group, all the children are below median weight for age and Height for age Z scores whereas in Mean pre transfusion haemoglobin  ≥8g/dl, group, 12.3% of the children are above the median Weight for age Zscore  and 6.2% of the children above the median Height for age Z score. Weight for age or Height for age Z scores has no correlation with age. With the increasing age, more thalassemic children had growth retardation, Height being affected more than Weight. Conclusion: Growth of thalassemic children during the first decade largely depends upon the maintenance of fairly normal haemoglobin between 9.5-10gm% with frequent blood transfusions and adequate chelation.

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