The Relationship between Immunological and Biological Markers in Thalassemia Patients after Blood Transfusion

Thalassemia patients require repeated blood transfusions, which may alter immunological and biological markers, potentially influencing inflammation, immune function, and complications. This study aimed to evaluate immunological and biological markers in transfused thalassemia patients and determine their associations with transfusion-related clinical and laboratory alterations. An analytical case–control study included 80 transfusion-dependent β-thalassemia patients and 40 healthy controls from January 2025 to April 2026. Clinical, transfusion, chelation, and anthropometric data were recorded. Blood samples were collected before scheduled transfusion. Complete blood count, ferritin, AST, ALT, and hs-CRP were measured using standardized laboratory methods, while serum IL-6, TNF-α, and IL-10 were quantified by ELISA. Cardiac function and growth parameters were assessed. Ethical approval and informed consent were obtained from all participants. The study included 80 thalassemia patients and 40 healthy controls. Patients demonstrated significantly higher CRP, IL-6, TNF-α, IL-10, ferritin, AST, and ALT levels, alongside significantly lower hemoglobin and left ventricular ejection fraction (all P<0.001). Patients received 3.5 ± 1.0 transfusions monthly, and 65.0% received iron-chelation therapy. Normal growth was observed in 85.0% of patients versus 95.0% of controls. Overall health status was significantly poorer among thalassemia patients compared with healthy controls (P<0.001). Transfusion-dependent thalassemia was associated with marked inflammatory, immunological, hematological, and biochemical alterations, particularly elevated cytokines, ferritin, and liver enzymes. These findings support integrated biomarker monitoring to identify transfusion-related complications, assess iron overload, and improve long-term clinical management of affected patients.