ß-thalassemia patients may be predisposed to premature atherosclerosis due to vascular dysfunction with increased arterial stiffness and endothelial deregulation. This assumption has been observed largely in adult with ß-thalassemia major. Whether atherosclerosis changes occur early in childhood of ß-thalassemia disease (BTD) patients is needed to be defined in order to prevent this cardiovascular complication in the young. Moreover, it remains uncertain if curative treatment with bone marrow transplantation (BMT) actually improves this vascular alteration.
Methods: Thirty-seven ß-thalassemia children, with an average age of 10.1±2.7 years, classified into: group 1 comprises 25 children with BTD currently managed with conventionally medical treatment and group 2 is BTD children who underwent BMT (n=12). Twenty nine age- matched healthy children were studied simultaneously and served as controls. The carotid stiffness index and intima-media thickness (IMT) was measured.
Result: Conventionally treated BTD children (group1) had a greater arterial stiffness index compare with the controls (4.57± 1.78 VS 2.87±1.07, p<0.001). While the carotid IMT was significantly greater in both groups of BTD children than controls (group 1: 0.45± 0.03 mm VS 0.34 ± 0.04 mm, p<0.001 and group 2: 0.43± 0.03 VS 0.34± 0.04, p<0.001).
Conclusion: Carotid IMT and arterial stiffness is increased in conventionally treated ß-thalassemia children, suggesting an early atherosclerotic change in these children. While BTD children underwent BMT had an increased carotid IMT but normal arterial stiffness. Whether BMT treatment alters the vascular complication is needed to be uncovered through future long term cohort study.