Thalassemia major is a severe anemia that requires blood transfusions. In this study, we searched into the hematological and biochemical status of βeta-thalassemia major patients in Koya. Hematological analysis revealed severe anemia in βeta-thalassemia p

Kochar Kh. Saleh; Esmail S. Kakey

doi:10.21271/ZJPAS.33.5.9

Authors

Kochar Kh. Saleh 1Department of Community Health, Koya Technical Institute, Erbil Polytechnic University, Erbil, Kurdistan Region-Iraq 2Department of Biology, College of Science, Firat University, Elazığ, 23000, Turkey
Esmail S. Kakey 3Department of Biology, Faculty of Science and Health, Koya University, Koya KOY45, Kurdistan Region-Iraq.

DOI:

https://doi.org/10.21271/ZJPAS.33.5.9

Keywords:

Anemia, βeta-thalassemia major, Hematological change, Biochemical change.

Abstract

Thalassemia major is a severe anemia that requires blood transfusions. In this study, we searched into the hematological and biochemical status of βeta-thalassemia major patients in Koya. Hematological analysis revealed severe anemia in βeta-thalassemia patients when compared to controls. The hemoglobin levels in patients were less than 30% of that of controls. Furthermore, patients had a significant leukocytosis compared to the controls. Red blood cell incidences are decreased except RDW, which were Hct includes (23.8±2.9 % vs. 34.6±2.3 %), MCV (71.8±7.1 fl vs. 77.5±4.1 fl), MCH (20.2±2.4 pg vs. 23.5 ± 2.2 pg) and MCHC (30.8±0.7 g/dl vs. 30.1±1.2 g/dl), while RDW % (20.5±9.7 % vs. 14.2±2.5 %). The linear regression analysis showed non-correlation between iron overload with RBC, WBC, and red blood cell incidences (hemoglobin (Hb), hematocrit (Hct), mean corpuscle hemoglobin (MCH), and mean corpuscle hemoglobin concentration (MCHC), while PLT count, mean corpuscular volume (MCV) and red cell distribution width (RDW) showed a significant positive correlation with iron overload. The biochemical characteristics of the patients showed a significant increase in the levels of liver enzymatic parameters, ALP, ALT, and AST as compared to controls.

References

Saleh, K.K. and Kakey, E.S. (2018). Some Molecular Characterization of β-Thalassemia Major In Koya City, International Conference on Pure and Applied Sciences, C Vol. 4 (4), pp: 64-68.

Ward, A., Caro, J.J., Green, T.C., Huybrechts, K., Arana, A., Wait, S., and Eleftheriou, A. (2002). An international survey of patients with thalassemia major and their views about sustaining life-long desferrioxamine use, BMC clinical pharmacology, C Vol. 2 (1), pp: 3.

Galanello, R. and Origa, R. (2010). Beta-thalassemia, Orphanet journal of rare diseases, C Vol. 5 (1), pp: 11.

Mehmetçik, G.J.Z.J.o.P. and Sciences, A. (2019). Estimation of MDA, CRP and Some hematological parameters in the mature Cypriot Thalassemia patients, Zanco Journal of Pure and Applied Sciences, C Vol. 31 (s4), pp: 143-149.

Al-Awamy, B.H. (2000). Thalassemia syndromes in Saudi Arabia, Saudi medical journal, C Vol. 21 (1), pp: 8-17.

Čokić, V.P., Smith, R.D., Biancotto, A., Noguchi, C.T., Puri, R.K., and Schechter, A.N. (2013). Globin gene expression in correlation with G protein-related genes during erythroid differentiation, BMC genomics, C Vol. 14 (1), pp: 116.

Sabri, M.S. (2017). Biochemical Study on Splenectomy and Non Splenectomy Iraqi Major Thalassemic Patients, Ibn AL-Haitham Journal For Pure and Applied Science, C Vol. 23 (1), pp: 254-259.

Jiffri, E.H., Bogari, N., Zidan, K.H., Teama, S., and Elhawary, N.A. (2010). Molecular updating of β-thalassemia mutations in the upper Egyptian population, Hemoglobin, C Vol. 34 (6), pp: 538-547.

Khattak, S.T. and Khan, J. (2006). Heterozygous beta thalassemia in parents of children with beta thalassemia major, Gomal Journal of Medical Sciences, C Vol. 4 (2), pp.

Saleh, K.K., Saman, R.A., and Rukhosh, E.M. (2019). Estimation of Serum Homeostasis Model Assessment-Insulin Resistance and Lipid Profile in Beta-thalassemia Major Patients and their Correlation with Iron Overload in Koya City, Polytechnic Journal, C Vol. 9 (2), pp. doi: 10.25156/ptj.v9n2y2019.pp125-132.

Hamamy, H.A. and Al-Allawi, N.A.S. (2013). Epidemiological profile of common haemoglobinopathies in Arab countries, Journal of community genetics, C Vol. 4 (2), pp: 147-167.

Napoli, N., Carmina, E., Bucchieri, S., Sferrazza, C., Rini, G.B., and Di Fede, G. (2006). Low serum levels of 25-hydroxy vitamin D in adults affected by thalassemia major or intermedia, Bone, C Vol. 38 (6), pp: 888-892.

Attia, M.M.A., Sayed, A.M., Ibrahim, F.A., Mohammed, A.S., and El-Alfy, M.S. (2011). Effects of antioxidant vitamins on the oxidant/antioxidant status and liver function in homozygous beta-thalassemia, Romanian J. Biophys, C Vol. 21 93-106.

Saleh, K.K., Dalkiliç, S., Dalkiliç, L.K., Hamarashid, B.R., and KIRBAĞ, S. (2020). Targeting cancer cells: from historic methods to modern chimeric antigen receptor (CAR) T-Cell strategies, AIMS Allergy Immunol, C Vol. 4 (2), pp: 32-49. doi: 10.3934/Allergy.2020004.

Ghasemi, A., Keikhaei, B., and Ghodsi, R. (2014). Side effects of hydroxyurea in patients with Thalassemia major and thalassemia intermedia and sickle cell anemia, Iran J Ped Hematol Oncol, C Vol. 4 (3), pp: 114-7.

Borgna‐Pignatti, C., Cappellini, M.D., De Stefano, P., Del Vecchio, G.C., Forni, G.L., Gamberini, M.R., Ghilardi, R., Origa, R., Piga, A., and Romeo, M.A. (2005). Survival and complications in thalassemia, Annals of the New York Academy of Sciences, C Vol. 1054 (1), pp: 40-47.

Waseem, F., Khemomal, K.A., and Sajid, R. (2011). Antioxidant status in beta thalassemia major: a single-center study, Indian Journal of Pathology and Microbiology, C Vol. 54 (4), pp: 761.

Aldudak, B., Karabay Bayazit, A., Noyan, A., Ozel, A., Anarat, A., Sasmaz, I., Kilinc, Y., Gali, E., Anarat, R., and Dikmen, N. (2000). Renal function in pediatric patients with beta-thalassemia major, Pediatr Nephrol, C Vol. 15 (1-2), pp: 109-12. doi: 10.1007/s004670000434.

Eldor, A. and Rachmilewitz, E.A. (2002). The hypercoagulable state in thalassemia, Blood, C Vol. 99 (1), pp: 36-43. doi: 10.1182/blood.v99.1.36.

Salih, M.I., Abdoulrahman, K.K.J.Z.J.o.P., and Sciences, A. (2016). Estimation of Anemia parameters in chronic renal failure patients on hemodialysis in Erbil Governorate, Zanco Journal of Pure and Applied Sciences, C Vol. 28 (6), pp: 75-80.

Ferru, E., Pantaleo, A., Carta, F., Mannu, F., Khadjavi, A., Gallo, V., Ronzoni, L., Graziadei, G., Cappellini, M.D., and Turrini, F. (2014). Thalassemic erythrocytes release microparticles loaded with hemichromes by redox activation of p72Syk kinase, Haematologica, C Vol. 99 (3), pp: 570-578.

Elgammal, M., Mourad, Z., Sadek, N., Abassy, H., and Ibrahim, H. (2012). Plasma levels of soluble endothelial protein C-receptor in patients with β-thalassemia, Alexandria Journal of Medicine, C Vol. 48 (4), pp: 283-288.

Meerang, M., Nair, J., Sirankapracha, P., Thephinlap, C., Srichairatanakool, S., Fucharoen, S., and Bartsch, H. (2008). Increased urinary 1, N6-ethenodeoxyadenosine and 3, N4-ethenodeoxycytidine excretion in thalassemia patients: markers for lipid peroxidation-induced DNA damage, Free Radical Biology and Medicine, C Vol. 44 (10), pp: 1863-1868.

Shamshirsaz, A.A., Bekheirnia, M.R., Kamgar, M., Pourzahedgilani, N., Bouzari, N., Habibzadeh, M., Hashemi, R., Shamshirsaz, A.A., Aghakhani, S., and Homayoun, H. (2003). Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran, BMC endocrine disorders, C Vol. 3 (1), pp: 4.

Mishra, A.K. and Tiwari, A. (2013). Iron overload in Beta thalassaemia major and intermedia patients, Maedica, C Vol. 8 (4), pp: 328.

Telfer, P., Prestcott, E., Holden, S., Walker, M., Hoffbrand, A., and Wonke, B. (2000). Hepatic iron concentration combined with long‐term monitoring of serum ferritin to predict complications of iron overload in thalassaemia major, British journal of haematology, C Vol. 110 (4), pp: 971-977.