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Multicenter Study
. 2019 Mar 20;14(3):e0214148.
doi: 10.1371/journal.pone.0214148. eCollection 2019.

Review of disease-related complications and management in adult patients with thalassemia: A multi-center study in Thailand

Suporn Chuncharunee  1 , Nattiya Teawtrakul  2 , Noppadol Siritanaratkul  3 , Nonlawan Chueamuangphan  4
Affiliations
Multicenter Study

Review of disease-related complications and management in adult patients with thalassemia: A multi-center study in Thailand

Suporn Chuncharunee et al. PLoS One. .

Abstract

Disease-related complications and management are different among patients with thalassemia. This study was aimed to review the prevalence, clinical risk factors for the complications and the management in patients with thalassemia in Thailand. A multicenter cross-sectional study was conducted in patients with thalassemia aged ≥ 18 years old. Thalassemia-related complications and management were reviewed. The clinical parameters significantly associated with the complications were analyzed by logistic regression methods. The prevalence of thalassemia-related complications was 100% in patients with transfusion-dependent thalassemia (TDT) and 58.8% in patients with non-transfusion-dependent thalassemia (NTDT). Advanced age was statistically associated with extramedullary hematopoiesis in both TDT and NTDT patients. Splenectomy was a significant risk factor for pulmonary hypertension in both groups of patients. Severe iron overload started earlier in patients with TDT than NTDT and was associated with diabetes mellitus (adjusted odds ratio (AOR) = 6.2, p-value = 0.02). Disease-related complications are more prevalent in patients with TDT than patients with NTDT. Splenectomy and advanced age were important risk factors for developing major complications in both groups. Early screening and management for specific disease-related complications should be considered in patients with thalassemia according to their clinical risk factors.

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Conflict of interest statement

No Novartis or any pharmaceutical company products nor honoraria were used to conduct any of the research as part of this publication. Chuncharunee S has received research funding and honoraria from Novartis Pharmaceuticals, Janssen-Cilag, Roche, and Celgene. Teawtrakul N received honoraria from Novartis and Janssen-Cilag. Siritanaratkul N. received research funding and honoraria from Novartis, Janssen-Cilag, Roche, and Pfizer. The remaining author declares no competing financial interests. There are no patents, products in development or marketed products to declare. This does not alter our adherence to the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Prevalence of the disease-related complications by age group in the 433 patients with thalassemia.
Fig 2
Fig 2. Prevalence of the severity of iron overload by age group in the 127 patients with transfusion-dependent thalassemia (TDT).
Fig 3
Fig 3. Prevalence of the severity of iron overload by age group in the 306 patients with non-transfusion-dependent thalassemia (NTDT).
See this image and copyright information in PMC

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