OBJECTIVE: Repeated transfussions can lead to iron overload and various new complications. Therefore, we aimed the correlation between serum ferritin, type of oral iron chelator and liver function test in children with transfusion-dependent thalassemia.
METHODS: This cross-sectional study was conducted at the Pediatric Hematology Oncology Outpatient Clinic, Dr. Soetomo, Surabaya from January to May 2019 for children aged less than 18 years with transfusion dependent thalassemia (TDT) who have received regular blood transfusion more than 4 times per year. Two iron chelators were used at our institution, deferipron and deferasirox. Serum ferritin and liver function tests were examined every 3 months consisting of alanine transaminase (ALT) and aspartate transaminase (AST). Spearman correlation is used to analyze data with p <0.05.
RESULT: Seventy five patients were included, consisting of 56% boys with the median age of 10(range 2 to 17) years. The median level of AST was 45(range 24 to 280) U/L, ALT was 48(range 15 to 330) U/L and ferritin serum was 3199(range 130 to 14,244) ng/mL. Serum ferritin was associated with ALT (p=0.017; r =0.275) but not for AST (p=0.650). The levels of AST and ALT did not differ significantly between TDT children who received deferiprone (n=64) and deferasirox (n=11), median 46(24-112) U/L and 38(28-280) U/L respectively and p=0.875 and p=0.653. 3/61 TDT children with defriprone and 1/10 with deferasirox had AST levels more than twice the upper limit of normal (90 U/L) with p=0.477 while for ALT more than 2 times the normal upper limit (70 U/L) on deferipron (8/64) and deferasirox (3/11) with p=0.199.
CONCLUSION: Increasing serum feritin has positive correlation with ALT but not for AST while liver function test in TDT children who use deferipron and deferasirox was similar.