Analysis of how Serum Ferritin and the Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) are correlated to Hepatic MRI T2* Findings in Children with Beta-Thalassemia Major

Roohollah  Edalatkhah; Marjan  Kargar; Maryamalsadat  Yazdanparast

doi:10.18502/ijpho.v14i3.15987

Roohollah Edalatkhah Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Marjan Kargar Shahid Sadoughi University of Medical Sciences
Maryamalsadat Yazdanparast Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ijpho.v14i3.15987

Keywords: Thalassemia, Blood transfusion, Iron overload, MRI T2*

Abstract

Background: Iron overload is a major complication in patients with beta-thalassemia major. Excessive iron accumulation leads to organ dysfunction. The regular assessment of iron is crucial to effectively manage iron overload in these patients. This study evaluated the correlation between serum ferritin levels, the Aspartate Aminotransferase-to-Platelet Ratio Index (APRI), and hepatic MRI T2* findings in children with beta-thalassemia major.

Materials and Methods: This retrospective analytical study was conducted at Shahid Sadoughi Hospital in Yazd in 2023. The research population comprised all the children under the age of 15 with beta-thalassemia major who had undergone multiple blood transfusions (at least ten units of blood).

Results: The participants in this study were 70 children with beta-thalassemia major, including 35 males and 35 females. Their mean age was 3.52 ± 10.76 years. The mean relaxation time of liver MRI T2* was 4.42 ± 4.91 ms. The participants also had the APRI score of 0.55 ± 1.90, the aspartate aminotransferase (AST) level of 23.82 ± 36.29, and the serum ferritin level of 285.01 ± 3244.04 (ng/mL). Based on MRI T2* results, 30% of the patients had a severe liver iron overload, 27.1% had a moderate overload, 21.4% had a severe overload, 18.6% had a mild overload, and 2.9% had near-normal iron levels.The AST level demonstrated a significant association with the type of chelation treatment (P = 0.003). The duration of blood transfusion (in years) showed a strong positive correlation with the patients' age (Pearson's coefficient = 0.996).

Conclusion: This study indicates the elevated serum ferritin levels and APRI scores in patients with beta-thalassemia major, most of whom have abnormal MRI T2* findings. However, no significant correlation was observed between the APRI score, serum ferritin level, and MRI T2* results.