title: T2(∗) MRI changes in the heart and liver of ex-thalassemic patients after hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Non-invasive methods like MRI-based techniques have been considered recently for assessment of liver and heart status in patients with thalassemia major (TM). The purpose of this study is to examine the alterations of hepatic and myocardial T2(∗) MRI values in TM patients after hematopoietic stem cell transplantation (HSCT) just before starting chelation therapy.
  
  
  METHODS
  The study included fifty-two TM patients with mean age of 7.6years who were referred to our center for HSCT. Before HSCT, patients underwent liver biopsy to determine fibrosis stage based on the Lucarelli classification. Hepatic and myocardial T2(∗) values before and 6months after transplantation were measured and analyzed.
  
  
  RESULTS
  There was not a statistically significant increase in myocardial T2(∗) values after HSCT (p-value=0.35). Hepatic T2(∗) values significantly decreased after HSCT (p-value <0.001), showing the liver status has been worsened. In subgroup analysis, post-HSCT hepatic T2(∗) values (adjusted for baseline values) were significantly higher in patients with graft-versus-host disease (GvHD) compared to non-GvHD patients (p-value=0.04).
  
  
  CONCLUSIONS
  The issue of iron overload is still remained as the main problem in ex-thalassemic patients after HSCT. We found T2(∗) MRI technique a quite beneficial method for following up the patients after transplantation. Obviously, planning large controlled trials associated with liver biopsy results after transplantation is required.
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Amir Ali
authors.initials: AA
authors.lastname: Hamidieh
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Sirous
authors.initials: S
authors.lastname: Tayebi
authors.affiliation: Department of Internal Medicine, Qazvin University of Medical Sciences, Iran. Electronic address: behfar.mrm@gmail.com.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Moeininia
authors.affiliation: Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Iran.
authors.forename: Ahmad Reza
authors.initials: AR
authors.lastname: Shamshiri
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Behfar
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Alimoghaddam
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Ghavamzadeh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D019190:Iron Overload / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009206:Myocardium / Q000473:pathology*; D017086:beta-Thalassemia / Q000150:complications / Q000473:pathology / Q000628:therapy*
keywords: Hematopoietic stem cell transplantation; T2(∗) MRI; Thalassemia major