The following is a summary of “Revisiting iron overload status and change thresholds as predictors of mortality in transfusion-dependent β-thalassemia: a 10-year cohort study,” published in the March 2024 issue of Hematology by Musallam et al.

Researchers started a retrospective study to identify iron overload thresholds associated with mortality in transfusion-dependent β-thalassemia (TDT) patients.

They involved 912 patients with TDT. Patients were monitored for a maximum of 10 years at medical facilities in Italy with a median age of 32 years, and 51.6% were female.

The results showed a crude mortality rate of 2.9%. After identifying the best predictive thresholds via receiver operating characteristic curve analyses, multivariate Cox regression models revealed significant associations. Patients with Period Average Serum Ferritin (SF) levels > 2145 ng/mL had a 7.1-fold higher risk of mortality (P<0.001) compared to those with SF ≤ 2145 ng/mL. Similarly, patients with Period Average Liver Iron Concentration (LIC) > 8 mg/g had a 20.2-fold increased risk (P<0.001) compared to those with LIC ≤ 8 mg/g. Patients with Index cardiac T2^* (cT2^*) < 27 ms had an 8.6-fold higher risk (P<0.001) of mortality compared to those with cT2^* ≥ 27 ms. Associations with mortality from cardiovascular disease were also observed at varying thresholds.

Investigators concluded that the findings can inform iron chelation therapy decisions by setting treatment goals, such as safe iron levels and significant changes over time.

Source: link.springer.com/article/10.1007/s00277-024-05715-x