Impact of transfusion frequency and iron overload on splenomegaly in β-Thalassemia Major: A cross-sectional Study

Objective: To examine the association between transfusion frequency, serum ferritin levels, and splenomegaly in β-thalassemia major (β-TM) patients. Methodology: A cross-sectional study of 194 β-TM patients (0–18 years) was conducted at thalassemia center in Hyderabad, Pakistan. Data on demographics, transfusion frequency, serum ferritin, and chelation adherence were collected. Splenomegaly was assessed clinically and via ultrasonography. Pearson’s correlation and chi-square tests were applied, with p ≤ 0.05 considered significant. Results: Splenomegaly was present in 61.34% of patients. Significant correlations were found between spleen size and transfusion frequency (r = 0.62, p<0.01), hemoglobin (r = -0.74, p<0.01), and bilirubin levels (r = 0.96, p<0.01). High transfusion rates (≥12/year), elevated ferritin (≥1500 ng/mL), and poor chelation adherence were strongly associated with splenomegaly (p<0.001). Conclusion: Frequent transfusions and poor chelation adherence contribute to iron overload and splenomegaly in β-TM. Optimizing transfusion schedules and enhancing chelation compliance can improve outcomes.