Anthropometric and Nutritional Status of Children with Transfusion-Dependent β-Thalassemia: Transfusion Characteristics and Iron Burden in a North Indian Cohort

Background: Growth impairment and undernutrition remain important concerns in children with transfusion-dependent β-thalassemia (TDT). Regular transfusion improves anemia but is accompanied by progressive iron loading, making simultaneous assessment of growth, transfusion adequacy, and iron burden important. The objective is to evaluate the anthropometric and nutritional status of children with TDT and evaluate their transfusion profile, iron burden, treatment characteristics, and relationships among age, pretransfusion hemoglobin, and serum ferritin. Material and Methods: This prospective observational study was conducted at the Thalassemia Day Care Centre of Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak. One hundred children aged 2–14 years who had been receiving regular red-cell transfusions every 2–3 weeks for at least one year were enrolled. Demographic, anthropometric, clinical, transfusion-related, treatment, and laboratory variables were prospectively recorded. Continuous variables were summarized as mean ± standard deviation and categorical variables as number and percentage. Pearson correlation coefficients were used to assess relationships among age, duration of regular transfusion, transfusion interval, pretransfusion hemoglobin, and serum ferritin. Results: The mean age was 8.60 ± 3.80 years; 56% were male and 84% had thalassemia major. Sixteen children (16%) were underweight, 82% had a normal BMI, and 2% were overweight. Mean pretransfusion hemoglobin was 5.20 ± 1.60 g/dL, mean transfusion interval was 21.80 ± 5.20 days, and mean serum ferritin was 1,892 ± 1,377 ng/mL. Ferritin correlated positively with age (r=0.31, p=0.002) and duration of regular transfusion (r=0.34, p<0.001), and inversely with transfusion interval (r=-0.25, p=0.010). Chelation therapy was documented in 64% of participants. Conclusion: Underweight affected approximately one in six children with TDT, while overweight was uncommon. Higher serum ferritin was associated with older age, longer duration of regular transfusion, and shorter transfusion intervals. These findings support regular growth surveillance together with optimization of transfusion therapy, serial iron monitoring, and individualized chelation.

Keywords: β-thalassemia; children; anthropometry; nutritional status; serum ferritin; blood transfusion; iron chelation.