Abstract Background: Thalassemia major, a severe form of thalassemia, is marked by inherited defects in haemoglobin (Hb) production, leading to anemia and potential growth retardation without regular blood transfusions. Objective: This study evaluated the growth patterns and the association between mean serum ferritin levels and growth in children with transfusion-dependent thalassemia major. Methods: The Shri Maharaja Gulab Singh Hospital, GMC Jammu, hosted this potential cohort study for duration of 1 year, from November 1, 2021, to October 31, 2022. A total of 125 transfusion-dependent thalassemia major patients aged 1–16 years were included. Anthropometric measurements (height, weight, and head circumference) were taken at baseline and every 3 months, compared with reference growth standards. Patients were grouped based on mean Hb levels before transfusion: <8 g/dL and ≥8 g/dL. Data on leukocyte count, platelet count, serum ferritin, and other biochemical parameters were collected. SPSS software was used to carry out the statistical analysis. Quantitative data were presented as means ± standard deviation or median with interquartile range, while categorical variables were shown as percentages. The Kolmogorov–Smirnov test was used to verify normality. In addition to Chi-square or Fisher’s exact tests for categorical variables, parametric (independent t -test and analysis of variance) and nonparametric (Mann–Whitney test) tests were employed. P <0.05 was regarded as statistically significant. Results: Among patients, 25 had short stature, while 72 (65.6%) had heights between the 3 rd and 50 th percentiles. Twenty patients (16%) were severely underweight. Higher proportions of patients aged 11–16 years had mean pretransfusion Hb <8 g/dL, with short stature more common in this group. Mean serum ferritin in patients with short stature was significantly higher (6432.32 ng/mL, P = 0.0004). Conclusion: Growth failure in transfusion-dependent thalassemia major worsens with age, especially in adolescents. Elevated serum ferritin levels negatively impact growth, highlighting the need for monitoring iron overload.
Bhat et al. (2025) studied this question.