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Abstract

A category of inherited blood illnesses known as beta-thalassemias are defined by abnormalities in the synthesis of hemoglobin beta chains, which can result in a wide range of phenotypes, from severe anemia to people who show no symptoms at all. People who have thalassemia major typically experience severe anemia during the first two years of life, necessitating frequent red blood cell (RBC) transfusions.

Management of individuals with β-thalassemia is centered on appropriate, safe blood transfusions (free of transfusion-transmitted illnesses) and prevention of iron excess. Complications from iron overload are brought on by routine transfusion therapy.

This study is a retrospective analysis of a sample of around 75 patients with beta thalassemia major (BTM) who were receiving iron chelation therapy and frequent transfusions at the Thalassemia Center at Children's Hospital in Karbala.

In this study, we compared the long-term effects of different iron chelation regimens (Desferioxamine vial (DFO), Deferasirox tablets (DFX), a combination of both (DFO+ DFX)) on iron overload as indicated by serum levels of ferritin, liver and kidney functions.

A significant difference was found among the three treatment protocols in serum levels of ferritin The ferritin levels were (1049µg/L ± 115.5) in DFX tablet treated group, (4325.5µg/L ± 299.8) in e DFO vial treated group; (4988.2 µg/L ± 438.4) in those treated with a combination of both DFX and DFO .

A significant difference was also found in hepatic function tests among the three treatment protocols as indicated by serum levels of glutamic-oxaloacetic transaminase (GOT) and Glutamic-pyruvic transaminase (GPT). For those treated with DFX tablet (GOT level expressed in units/ Liter are (24.51±1.86) and GPT level (18.72 ± 2.07)), for those treated with DFO vial (GOT level (28.05±2.39) and GPT level (29.57±2.54)); for those treated with combination therapy of both DFO+ DFX (GOT level (31.15±2.06) and GPT level (31.99±2.23).

No significant difference was found among the three treatment protocols in renal functions test as indicated by urea and creatinine serum levels.

In conclusion those treated with DFX had considerably lower serum ferritin levels than those treated with DFO alone or in combination with DFX. While there were no discernible variations in the concentrations of urea and creatinine between the treatment regimens, the liver enzymes of those treated with DFO+ DFX were significantly higher.

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