Mansory Eman M, Abdulrahman Lina M, Osman Balsam, Alsiyoufi Sawsan M, Ruckn Assil F, Aljedaani Marwa, Hassan Nemmat, Barefah Ahmed S, Alahwal Hatem M, Daghistani Yassir, Bahashwan Salem M, Almohammadi Abdullah T, Radhwi Osman O
Hematology Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
Mediterr J Hematol Infect Dis. 2025 Sep 1;17(1):e2025055. doi: 10.4084/MJHID.2025.055. eCollection 2025.
Thalassemia is an inherited blood disorder characterized by abnormal hemoglobin production, leading to chronic anemia. Patients, particularly those who are transfusion-dependent, face a heightened risk of infections due to disease-related factors like anemia and treatment-related complications such as iron overload and splenectomy. This study explores the factors contributing to infections in thalassemia patients to improve management strategies.
A retrospective analysis was conducted on 303 patients with thalassemia at a tertiary care center from 2007 to 2022. Data were collected on demographics, transfusion dependency, splenectomy status, ferritin levels, vaccination history, and ulture results. Logistic regression analysis was used to identify infection risk factors, with significance set at p-value < 0.05.
Out of 303 patients, 72 (23.8%) experienced culture-positive infections, with Escherichia coli being the most isolated pathogen. Patients with infections had significantly higher ferritin levels and were less likely to be on chelation therapy. Chelation therapy was significantly associated with a reduced risk of infection (OR 0.18, < 0.001). Higher serum albumin levels were also associated with lower odds of infection (OR 0.92, < 0.001). Mortality was significantly higher among patients with positive cultures compared to those without (22% vs. 3%, < 0.001).
This study highlights the strong link between iron overload, chelation, and risk of infection in thalassemia patients. Effective management, including proper chelation therapy and monitoring ferritin levels, is critical for reducing infections and improving outcomes. Further studies are needed to confirm these findings and guide future management strategies.
地中海贫血是一种遗传性血液疾病，其特征是血红蛋白生成异常，导致慢性贫血。患者，尤其是那些依赖输血的患者，由于贫血等疾病相关因素以及铁过载和脾切除术等治疗相关并发症，面临更高的感染风险。本研究探讨导致地中海贫血患者感染的因素，以改进管理策略。
对一家三级医疗中心2007年至2022年的303例地中海贫血患者进行回顾性分析。收集了人口统计学、输血依赖情况、脾切除状态、铁蛋白水平、疫苗接种史和培养结果等数据。采用逻辑回归分析确定感染危险因素，显著性设定为p值<0.05。
在303例患者中，72例（23.8%）出现培养阳性感染，大肠杆菌是最常见的分离病原体。感染患者的铁蛋白水平显著更高，接受螯合疗法的可能性更小。螯合疗法与感染风险降低显著相关（OR 0.18，<0.001）。较高的血清白蛋白水平也与较低的感染几率相关（OR 0.92，<0.001）。培养阳性患者的死亡率显著高于培养阴性患者（22%对3%，<0.001）。
本研究强调了地中海贫血患者铁过载、螯合疗法与感染风险之间的紧密联系。有效的管理，包括适当的螯合疗法和监测铁蛋白水平，对于减少感染和改善预后至关重要。需要进一步研究来证实这些发现并指导未来的管理策略。
