title: Evaluation of the Relationship Between Hb F Levels and Nucleated Red Blood Cells with Morbidity in Non Transfusion-Dependent Thalassemia Patients.
abstract: Recognition of risk factors of morbidities in patients with β-thalassemia intermedia (β-TI) is an important issue that must be evaluated. Non transfusion-dependent thalassemia patients referred to the outpatient clinic of Shiraz University of Medical Science, Shiraz, South Iran were enrolled in this study between 2013 and 2014. Two peripheral blood smears were prepared for evaluating developmental stage of normoblasts. One hundred and thirty-one patients with ages ranging from 3 to 42 years (mean: 23.35 ± 7.9) were selected. Sixty-seven patients had at least one morbidity (51.1%). Osteoporosis and gallstones were the most common morbidities (33.6 and 24.4%, respectively). In the univariate model, hemoglobin (Hb), ferritin, Hb F, developmental stage of normoblasts and hydroxyurea (HU) therapy did not differ between patients with and without morbidity (p > 0.05) but mean age of patients and mean number of normoblasts were higher in patients with morbidity (p = 0.026 and p = 0.012, respectively). In the regression model, sex and splenectomy status were different between patients with and without morbidity. It seems that females and splenectomy are risk factors for morbidity in non transfusion-dependent thalassemia patients. [Sex: odds ratio (OR) = 2.21, 95% confidence interval (95% CI): 1.04-4.72, p = 0.39. Splenectomy: OR = 3.10, 95% CI: 1.12-8.59, p = 0.029.] This study shows that Hb F level and developmental stage of normoblasts does not effect the incidence of morbidities in non transfusion-dependent thalassemia patients but sex and splenectomy were effective factors in development of morbidities. Thus, splenectomy should be avoided as much as possible in patients with non transfusion-dependent thalassemia.
authors.affiliation: a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
authors.affiliation: b Hematology Research Center, Pediatric Department, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran , and.
authors.forename: Parisa
authors.initials: P
authors.lastname: Jooya
authors.affiliation: a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran.
authors.forename: Sezaneh
authors.initials: S
authors.lastname: Haghpanah
authors.affiliation: c Pathology Department, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran.
authors.forename: Maral
authors.initials: M
authors.lastname: Mokhtari
authors.affiliation: a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Rezaei
authors.affiliation: b Hematology Research Center, Pediatric Department, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran , and.
authors.forename: Maede
authors.initials: M
authors.lastname: Fath
authors.affiliation: a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Islamic Republic of Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Parand
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004900:Erythroblasts / Q000473:pathology*; D004906:Erythrocyte Count; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis*; D042882:Gallstones; D006801:Humans; D007492:Iran; D008297:Male; D009017:Morbidity; D010024:Osteoporosis; D012307:Risk Factors; D012737:Sex Factors; D013156:Splenectomy; D013789:Thalassemia / Q000453:epidemiology*
chemical_list: D005319:Fetal Hemoglobin
keywords: Hb F; hydroxyurea (HU); morbidity; nucleated red blood cells (NRBCs); β-Thalassemia intermedia (β-TI)