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Background: Thalassemia syndromes are the most prevalent hereditary hemoglobinopathies in the world. Iran is located on the thalassemia belt. In this study, the effect of Xmn -1 polymorphism and coinheritance of alpha mutations on age at first transfusion and also transfusion interval in Iranian thalassemic patients with homozygous IVSI-5 mutation were assessed. Materials and Methods: In this retrospective cross-sectional study 154 transfusion dependent thalassemia (TDT) patients (140 patients with β-thalassemia major and 14 cases with β-thalassemia intermedia) who were homozygote of IVSI-5 mutation have been participated. Blood samples were collected from participants using EDTA containers for genomic DNA analysis. DNA extraction and amplification-refractory mutation to determine the Xmn -1 polymorphism were performed. Multiplex PCR was performed to identify alpha globin deletions. Results: The mean age of participants was 29±7, 58 of them were male and 96 were female. A significant relation between presence of Xmn -1 polymorphism and age at receiving first transfusion was detected. Coinheritance of alpha thalassemia mutation does not have significant effect on age at first transfusion or transfusion interval. Conclusion: Presence of Xmn -1 polymorphism can delay the onset of transfusion in patients with homozygote IVSI-5 mutation. [ABSTRACT FROM AUTHOR]

Background: One of the most important phenotypic modifying factors for thalassemia is the presence of Xmn1 polymorphism. This retrospective study was performed to investigate the overall prevalence of Xmn1 polymorphism among Iranian β-thalassemia patients with homozygote IVSII-1mutation and to assess the relationship between Xmn1 polymorphism with patients' hemoglobin levels and the response to hydroxyurea (Hu) therapy. Materials and Methods: The present cross sectional study included 112 β-thalassemia patients with homozygote IVSII-1 mutation. Laboratory investigations included complete blood count and routine hematological indices were measured by Sysmex K1000 (Japan) blood auto analyzer. To find the state of Xmn1 polymorphism, blood samples were collected from patients using EDTA containers for genomic DNA analysis. DNA extraction and amplification-refractory mutation to determine the Xmn-1 polymorphism were performed. Results: In total, 206 thalassemia patients including 112 patients diagnosed as thalassemia major and 94 patients diagnosed as thalassemia intermediate entered the study. The mean age at the start of transfusion was 5 ± 6.4 years old, and all of the patients received hydroxyurea. Twenty eight patients (14%) did not show any Xmn 1 polymorphisms (- / -), and 178 patients (86%) showed polymorphism either in one loci (- / +, 44 patients, 21.3%) or both loci (+ / +, 134 patients, 65%). Patients with Xmn1 polymorphism showed significantly higher age at diagnosis (p=0.002), higher age at start of transfusion (p=0.001), higher hemoglobin levels after treatment with hydroxyurea (p=0.005), and lower transfusion dependency (P=0.044). Conclusion: The presence of Xmn1 polymorphism led to a delay in onset of blood transfusions, higher hemoglobin levels, better response to hydroxyurea treatment and milder phenotypic presentation among thalassemia patients with IVSII-1 mutation. [ABSTRACT FROM AUTHOR]

Introduction: Major thalassemic patients need lifelong transfusions. The consequence of these repeated transfusions is iron accumulation in different organs. The main aim of the present study was to investigate the correlation between heart, liver and pancreas hemosiderosis in thalassemic patients from Iran. Methods: This cross-sectional study was conducted on 164 major thalassemia patients at Zafar Adult Thalassemia Center, a referral thalassemia center in Tehran, Iran, from May to November 2014. All patients were on regular blood transfusion at 2-4 week intervals to keep their hemoglobin at a level of 7-9 gr/dL before each transfusion. Demographic data were gathered from patients' history. MRI T2* of liver, heart and pancreas were performed for all patients. Results: There was a moderate correlation between pancreatic T2* and cardiac T2* relaxation times (r = 0.42, P < 0.001), a weak to moderate correlation between T2* of pancreas and liver (r = 0.41, P < 0.001), and a weak correlation between T2* relaxation times of heart and liver (r = 0.31, P< 0.001). Conclusion: Poor correlation between liver and heart, as well as a weak to moderate correlation between pancreas and liver T2* relaxation times indicate that relying on liver MRI T2* to predict the exact condition of pancreas or heart iron overload might not be a reliable approach in thalassemia major patients. Our findings suggest the advantage of using pancreas and heart MRI T2* as a non-invasive method for estimation of iron overload instead of relying on liver MRI T2*. [ABSTRACT FROM AUTHOR]