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ArticleIndian pediatrics2025

Risk Stratification-Based Therapy for Children with E-beta Thalassemia: A 20-Year Follow-Up Study.

Kavitha Ganesan, Suresh Duraisamy, Anupama Nair, Vijayshree Muthukumar, Anurag Nalla Reddy, Minakshi Balwani, Nithya Seshadri, Ramya Uppuluri, Revathi Raj

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Article in Indian pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Kavitha GanesanDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India. kavitha5293dr@gmail.com.ORCID 0009-0000-9486-7219
Suresh DuraisamyDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Anupama NairDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Vijayshree MuthukumarDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Anurag Nalla ReddyDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Minakshi BalwaniDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Nithya SeshadriDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Ramya UppuluriDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.
Revathi RajDepartment of Pediatric Hematology, Oncology, Blood, and Marrow Transplantation, Apollo Cancer Hospitals, 320, Padma Complex, Anna Salai, Teynampet, Chennai, Tamil Nadu, 600035, India.

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6 · The paper itself

Abstract

objectiveTo present risk stratification-based follow-up of children with E-beta thalassemia.

methodsChildren with E-beta thalassemia between August 2002 and August 2022 were classified as mild, moderate, or severe disease using Mahidol scoring. Children in the moderate group with < 20 or ≥ 20 nucleated red blood cells (nRBCs) per 100 white blood cells were clubbed with mild or severe phenotype, respectively. Children with mild/moderate severity received hydroxyurea (HU) and those with severe disease received regular transfusions.

resultsOut of 104 children (median age of onset 3.5 years), 30 (29%), 46 (44%), and 28 (27%) were categorized as mild, moderate, and severe disease, at initial presentation. Based on nRBC count, 27 and 19 children in moderate category were recategorized as mild to moderate and moderate to severe. Fifty-six, 19, and 29 children received HU, transfusions with HU, and monthly transfusion and chelation, respectively. At a median follow-up of 8 years, 67/93 (72%) children classified as "mild to moderate" remained well on HU, and 26/93 (28%) children classified as "moderate to severe" remained on regular transfusions.

conclusionUsing nRBCs in addition to Mahidol scoring can serve as a useful tool to individualize therapy.

Indexed as

beta-ThalassemiaBlood TransfusionHydroxyureaAdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleRisk AssessmentSeverity of Illness IndexHydroxyureaBeta-globin geneHydroxyureaIndiaMahidol scoringNon-transfusion-dependent thalassemianRBCs

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