ASSESSMENT OF QUALITY OF LIFE, COMPLICATIONS AND POST-TRANSFUSION ADVERSE REACTIONS IN THALASSEMIA PEDIATRIC IN TERTIARY CARE HOSPITAL
Objective: To assess the quality of life, investigate complications and adverse transfusion reactions post blood transfusion in thalassemia pediatric.
Methods: A prospective, observational study was conducted over a period of six months in the pediatric department of Bharati hospital and research center, Pune. Thalassemia patient profile form was used for collecting demographic details, to record adverse transfusion reactions and complications. Using PedsQLâ„¢ (Pediatric Quality of Life Inventory) questionnaire thalassemia patients, and the control group was interviewed to assess their quality of life.
Results: Out of 39 patients who were enrolled, 28 patients were above the age of 3 y; their overall quality of life score was significantly lower in thalassemia pediatric than healthy control. School function was a most affected domain. 53.84% had post-transfusion fever, 5.1% of respiratory distress while 41.06% had myalgia, swelling at IV site, headache, and vomiting. Out of 39 patients, 24 patients examined for complications; 33.34% had hepatosplenomegaly, 25% had infections, 16.66% had splenomegaly, 13.88% had cardiac complications, 8.34% had bone deformity, and 2.78% had growth failure.
Conclusion: It was found that there was a significant decrease in the quality of life domains in thalassemia pediatric compared to control group. School domain was most affected. Hepatosplenomegaly is one of the leading complications observed in this study. Most common transfusion-related reaction was post-transfusion fever. Public awareness and preventive measures such as pre-marital and prenatal testing should be done to eliminate this fatal disease.
Keywords: Thalassemia, Quality of life, PedsQLâ„¢, Adverse transfusion reactions, Complication in Thalassemia.
2. Thalassemias. Available from: http://www.nhlbi.nih.gov/book/export/html/4874. [Last accessed on 12 Sep 2014].
3. P Sandhya Rani, S Vijayakumar, N Chandana. Betaâ€“thalassemia: mini review. Int J Pharmacol Res 2013;3:71- 9.
4. Kirti Grow, Minakshi Vashist, Shiksha Sharma. Beta thalassemia in india: current status and the challenges ahead. Int J Pharm Pharm Sci 2014;6:28-33.
5. Farzana Sayani, Molly Warner, John Wu. Guidelines for the Clinical Care of Patients with Thalassemia in Canada. Canada: Anemia Institute for Research and Education; 2009. Available from: http://www.thalassemia.ca/wp-content/uploads/ Thalassemia-Guidelines_LR.pdf. [Last accessed on 10 Sep 2014].
6. Hira Tahir, Syeda Amna Shahid, Khawaja Tahir Mahmood. Complications in thalassemia patients receiving blood transfusion. J Biomed Sci Res 2011;3:339- 46.
7. Kirti Grow, Minakshi Vashist, Shiksha Sharma. Associated complications in beta-thalassemia patients. IOSR J Pharm 2013;3:22-5.
8. Melody J Cunningham, Eric A Macklin, Ellis J Neufeld. Complications of beta-thalassemia major in North America. Am Soc Haematol 2004;104:34-9.
9. Mohaisen H Adaay, Moayed M Al-Anzy, Khudair A Al-Tikriti. Some observations on the occurrence of Î²-thalassemia in mosul. Iraq Joinerysoft Microsoft Pinpoint 2011;9:270-4.
10. Mehrnoosh Doroudchi, Ali Akbar Asadi Pooya. Thalassemia major and consanguinity in shiraz city, Iran. Turk J Hematol 2004;21:127-30.
11. Qurat-ul-Ain, Muhammad Hassan, Shahid Mahboob Rana. Prevalence of beta-thalassemic patients associated with consanguinity and anti-HCV-antibody positivityâ€“a cross-sectional study. Pak J Zool 2011;43:29-36.
12. Mohammadreza Sattari, Dorna Sheykhi, Alireza Nikanfar. The adverse effects of thalassemia treatments including blood transfusion and main pharmacological therapies. Pharm Sci 2013;18:199-204.
13. Giovanni Caocci, Fabio Efficace, Francesca Ciotti. Health-related quality of life in Middle Eastern children with beta-thalassemia. BMC Blood Disord 2012;12:1-7.
14. Sharaf KhH, Moayad M Y Al Anzym, Mustaffa NG. Certain hematological values of the beta thalassemia major among mosul population. Tikrit J Pure Sci 2006;24:1-6.
15. G Shanthi, D Balasubramaniam, R Srinivasan. Clinical and demographical studies of beta thalassemia in tamilnadu. Res J Pharm Biol Chem Sci 2013;4:952- 6.
16. Tazeen Majeed, Ujala Nayyar, Mohammed Adil Akhther. Frequency of Î²-thalassemia trait in families of thalassemia major patients, Lahore. J Ayub Med College Abbottabad 2013;25:58-60.
17. Ansari SH, Nida Baig, Tahir Sultan Shamsi. Screening immediate family members for carrier identification and counseling: a cost-effective and practical approach. J Pak Med Assoc 2012;62:1314â€“7.
18. Hashemizadeh H, Noori R, Kolagari SH. Assessment hepatomegaly and liver enzymes in 100 patients with beta thalassemia major in mashhad, Iran. Iran J Haematol Onco 2012;2:171-7.