The incidence of nontransfusion-transmitted infectious diseases in β thalassemia major patients at Cipto Mangunkusumo Hospital
Keywords:
thalassemia, immune response, incidence of infection
Abstract
Background The statement that thalassemic children are moreprone to infection than normal children has been accepted as a
part of thalassemia literatures for years. Recently this concept has
been questioned, and certainly it has impressed the clinicians that
the incidence of infection in thalassemia in early childhood is re-
duced by adequate blood transfusion although this has not been
documented. However, iron overload favors bacteria to acquire
iron necessary for their growth. Excess iron deposit may damage
immune response in thalassemic patients.
Objective The aim of this study was to find out whether there was
any increasing episode of nontransfusion-transmitted infectious dis-
eases in thalassemic patients.
Design Observational, cross sectional study.
Setting Thalassemia outpatient clinic at the Department of Child
Health, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Patient Two hundreds subjects by consecutive sampling, grouped
by their total volume of transfusion into ≥5 liters or <5 liters groups.
Results The numbers of patients receiving transfusion ≥5 liters
who had 1,2,3,4 and 5 times episodes of influenza in 6-month pe-
riod were 69, 20, 3, 2, and 2 out of 173 patients respectively and
in patients receiving transfusion less than 5 liters,14/27 had influ-
enza for 1-2 times in 6-month period. The incidence of diarrhea in
patients receiving transfusion ≥5 liters was 11.5%, once to twice in
6 months and in patients receiving transfusion less than 5 liters, 7/
27, 1-2 times in 6 months. There was no difference in the inci-
dence of influenza and diarrhea between the two groups.
Conclusion It seemed that there was no any increasing incidence
of nontransfusion-transmitted infectious diseases in thalassemic
patients in accordance with total volume of blood transfusions
References
1. Wahidiyat I. Historical perspective of thalassemia man-
agement in Indonesia. Proceedings of the Symposium
of New Horizon in Thalassemia Control; 2002 June
11-12; Jakarta, Indonesia.
2. Weathearall D J. Thalassemias. In: Beutler E, Lichtman
M, Coller B, Kipps T, editors. Williams Hematology.
5 th ed. New York: McGraw-Hill Inc; 1995. p. 581-11.
3. Weatherall DJ, Clegg JB. The β thalassaemias. In:
Weatherall DJ, Clegg JB, editors. The thalassaemia syn-
drome. London: Blackwell Scientific Publications;
1981. p. 164-8.
4. Wanachiwanawin W. Immune response in thalassemia.
Proceedings of the 2 nd ASEAN conference on thalas-
semia and update in hematology; 1997 Sept 8-10;
Jakarta, Indonesia.
5. Montalembert M, Girot R, Mattlinger B, Lefrere J.
Transfusion-dependent thalassemia: viral complica-
tions (epidemiology and follow-up). Semin Hematol
1995; 280-7.
6. Menitove J. Transfusion-transmitted infection: update.
Semin Hematol 1996;290-1.
7. Tung B, Kowdley K. Clinical management of iron over-
load. Gastrointestinal Clin 1998; 27:637-54.
8. Bottomley S. Secondary iron overload disorders. Iron
overloading disorders and iron regulation. Semin
Hematol 1998;35:77-86.
9. Walker EM Jr, Walker SM. Effects of iron overload on
immune system [abstract]. Ann Clin Lab Sci 2000;
30:354-65.
10. Cunningham-Rundles S, Giardina PJ, Grady RW,
Califano C, McKenzie P, De Sousa M. Effect of trans-
fusional iron overload on immune response. J infect
Dis 2000; 84(Suppl 1): S115-21.
11. Lombardi G, Matera R, Minervini MM, Cascavilla N,
D’Arcangelo P, Carotenuto M, et al. Serum levels of
cytokines and soluble antigens in polytransfused patients
with betathalassemia major: relationship to immune sta-
tus [abstract]. Haematologica 1994;79:406-12.
agement in Indonesia. Proceedings of the Symposium
of New Horizon in Thalassemia Control; 2002 June
11-12; Jakarta, Indonesia.
2. Weathearall D J. Thalassemias. In: Beutler E, Lichtman
M, Coller B, Kipps T, editors. Williams Hematology.
5 th ed. New York: McGraw-Hill Inc; 1995. p. 581-11.
3. Weatherall DJ, Clegg JB. The β thalassaemias. In:
Weatherall DJ, Clegg JB, editors. The thalassaemia syn-
drome. London: Blackwell Scientific Publications;
1981. p. 164-8.
4. Wanachiwanawin W. Immune response in thalassemia.
Proceedings of the 2 nd ASEAN conference on thalas-
semia and update in hematology; 1997 Sept 8-10;
Jakarta, Indonesia.
5. Montalembert M, Girot R, Mattlinger B, Lefrere J.
Transfusion-dependent thalassemia: viral complica-
tions (epidemiology and follow-up). Semin Hematol
1995; 280-7.
6. Menitove J. Transfusion-transmitted infection: update.
Semin Hematol 1996;290-1.
7. Tung B, Kowdley K. Clinical management of iron over-
load. Gastrointestinal Clin 1998; 27:637-54.
8. Bottomley S. Secondary iron overload disorders. Iron
overloading disorders and iron regulation. Semin
Hematol 1998;35:77-86.
9. Walker EM Jr, Walker SM. Effects of iron overload on
immune system [abstract]. Ann Clin Lab Sci 2000;
30:354-65.
10. Cunningham-Rundles S, Giardina PJ, Grady RW,
Califano C, McKenzie P, De Sousa M. Effect of trans-
fusional iron overload on immune response. J infect
Dis 2000; 84(Suppl 1): S115-21.
11. Lombardi G, Matera R, Minervini MM, Cascavilla N,
D’Arcangelo P, Carotenuto M, et al. Serum levels of
cytokines and soluble antigens in polytransfused patients
with betathalassemia major: relationship to immune sta-
tus [abstract]. Haematologica 1994;79:406-12.
Published
2016-10-10
How to Cite
1.
Munasir Z, Ruth A, Tumbelaka A. The incidence of nontransfusion-transmitted infectious diseases in β thalassemia major patients at Cipto Mangunkusumo Hospital. PI [Internet]. 10Oct.2016 [cited 23Dec.2024];43(6):216-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/697
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-09-24
Accepted 2016-09-24
Published 2016-10-10
Accepted 2016-09-24
Published 2016-10-10
