PREVALENCE OF BLOOD TRANSFUSION-ASSOCIATED COMPLICATIONS AMONG BETA THALASSEMIA PATIENTS IN SOUTHERN PUNJAB: A MULTICENTER STUDY AT A GLANCE
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Keywords
Beta-thalassemia, transfusion-associated complications, Southern Punjab, hepatitis C virus, iron overload, alloimmunization, endocrine dysfunction.
Abstract
Background: Beta-thalassemia major is a common inherited hemoglobinopathy in Pakistan, particularly in Southern Punjab, where high consanguinity which contribute to its high prevalence. Although regular blood transfusion is the cornerstone of treatment, it predisposes patients to a spectrum of transfusion-associated complications, both infectious and non-infectious, which significantly affect long-term morbidity and mortality.
Aims & Objective: This study aimed to determine the prevalence of transfusion-related infectious, non-infectious, and long-term complications among β-thalassemia patients in Southern. Methodology: A multicenter, cross-sectional study was conducted between January and July 2025 across three tertiary thalassemia centers in Lodhran, Bahawalpur and Multan. A total of 345 transfusion-dependent β-thalassemia patients were enrolled through stratified random sampling. Data were collected using structured questionnaires, medical record review, and laboratory investigations including HBsAg, anti-HCV, HIV ELISA, serum ferritin, liver and thyroid function tests. Descriptive statistics determined prevalence rates, and logistic regression was performed to identify predictors of complications.
Results & Findings: The mean age of patients was 12.6 ± 6.3 years, with a male-to-female ratio of 1.2:1. Infectious complications included anti-HCV positivity (32.5%), HBsAg positivity (5.2%), and HIV (<1%). Iron overload (serum ferritin >2500 ng/mL) was found in 72.5%, significantly linked with poor compliance to chelation therapy (p<0.001). Alloimmunization occurred in 14.8%, while febrile non-hemolytic and allergic reactions were seen in 11.6% and 8.4%, respectively. Long-term sequelae comprised delayed puberty/hypogonadism (30.6%), growth retardation (21.1%), hypothyroidism (14.9%), diabetes mellitus (10.9%), and hepatic fibrosis/cirrhosis (12.9%). Logistic regression highlighted transfusion frequency (>2/month), early transfusion onset, and poor chelation compliance as independent risk factors.
Conclusion: Transfusion-dependent β-thalassemia patients in Southern Punjab exhibit a high burden of both infectious and non-infectious complications, with HCV and iron overload being most prevalent. Strengthening donor screening, expanding access to chelation therapy, and structured long-term follow-up are essential to reduce complications and improve survival outcomes.
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Uzma Chohan
Department of Pathology, Shahida Islam Medical College Lodhran, Pakistan.
Ujala Aymun
Department of Pathology, Avicenna Medical College & Hospital, Lahore, Pakistan.
Maryam Khanzada Rajput
Department of Pathology, Diagnostic & Research Lab, Bilawal Medical College Jamshoro, Pakistan.
Tooba Ammar
Department of Hematology, Shaikh Zayed Post Graduate Medical Institute Lahore, Pakistan.
Javaeria Abdullah
Department of Hematology, Shaikh Zayed Post Graduate Medical Institute Lahore, Pakistan.
Hussain Farooq
Department of Hematology, Shaikh Zayed Post Graduate Medical Institute Lahore, Pakistan.