Description

Kamperidis et al reported poor prognostic factors in patients with transfusion-dependent thalassemia. These can help to identify a patient who may benefit from more aggressive management. The authors are from Aristotle University of Thessaloniki, AHEPA University Hospital, Ippokratio University Hospital and Papanikolaou Hospital in Greece.


Patient selection: transfusion-dependent thalassemia

 

Parameters:

(1) tricuspid valve regurgitation maximum velocity (TR Vmax) in meters per second

(2) serum ferritin in ng/mL

(3) cardiac magnetic resonance (CMR) T2* in milliseconds

 

Parameter

Finding

Points

TR Vmax

<= 2.8 m/s

0

 

> 2.8 m/s

1

serum ferritin

< 2,000 ng/mL

0

 

>= 2,000 ng/mL

1

CMR T2*

> 20 ms

0

 

<= 20 ms

1

 

total number of risk factors associated with worse prognosis =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The chances of survival decreases as the number of risk factors increase.

 

Targets for therapy:

(1) serum ferritin <= 1,700 ng/mL

(2) CMR T2* >= 34 milliseconds


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