Comparison of Hematological Parameters Between Splenectomized and Non-Splenectomized Transfusion-Dependent Thalassemia Patients

Open Access

Abstract

Background: Thalassemia is a common inherited blood disorder caused by mutations in the hemoglobin gene clusters, leading to defective globin chain synthesis and, in severe cases, transfusion-dependent anemia. The purpose of the study is to evaluate the impact of splenectomy on iron overload by comparing serum ferritin levels between splenectomized and non-splenectomized transfusion-dependent thalassemia patients. Methods & Materials: This cross-sectional comparative study at the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, included 60 transfusion-dependent thalassemia patients (30 splenectomized, 30 non-splenectomized) to compare hematological parameters, transfusion interval, and serum ferritin. Blood samples were analyzed for complete blood count and peripheral blood film (Sysmex XN-2000) and serum ferritin (Chemiluminescent Immunoassay, Liaison XL). Data were compared using Student’s t-test and chi-square test (p<0.05). Results: Among 60 transfusion-dependent thalassemia patients, most were 11–20 years old (mean 17.78 ± 6.57 vs 18.87 ± 10.95 years; p = 0.644) and male (61.7%; p = 0.184). Splenectomized patients had longer transfusion intervals (>4 weeks: 60.0% vs 16.7%; p = 0.001), higher MCV, WBC, platelet counts, and serum ferritin (all p < 0.05), while peripheral blood film patterns were similar (p = 0.117), with severe anemia more common in splenectomized patients. Conclusion: Splenectomy in transfusion-dependent thalassemia reduces transfusion frequency and alters hematological parameters but increases iron overload, highlighting the need for careful iron monitoring.