Putu Niken Ayu Amrita and Siprianus Ugroseno Yudho Bintoro and Made Putra Sedana and Muhammad Noordiansyah and Pradana Zaky Ramadhan and Merlyna Savitri and Ami Ashariati Prayoga (2020) Serum ferritin level affects T lymphocyte CD4, CD8, and CD4/CD8 ratio in transfusion-dependent beta-thalassemia. Drug Invention Today, 13 (6). pp. 887-892. ISSN 09757619

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Abstract

Background: Chronic blood transfusions and hemolysis are the major causes of secondary iron overloading transfusion- dependent beta-thalassemia. Iron overload can cause several organ complications including immune alteration. Infection due to immune alteration is number two leading cause of mortality in thalassemia. Research on the correlation of ferritin as iron overload marker and T lymphocyte subsets alteration in adult thalassemia patients are still rare and require further study. Objective: The objective of the study was to study the correlation of iron overload and T lymphocyte subsets CD4, CD8, and CD4/CD8 ratio in adult transfusion-dependent beta-thalassemia. Methods: The study was cross-sectional observational analytic study conducted on 36 subjects with transfusion-dependent beta-thalassemia diagnosed by clinical examination and laboratory high-performance liquid chromatography followed up at Hematology Clinic, Dr. Soetomo Teaching Hospital Surabaya, Indonesia. Ferritin serum was measured by chemiluminescence immunoassay method, while CD4, CD8 counts, and CD4/CD8 ratio were assessed by flow cytometry with antigen for CD3/CD4/CD8. Results: There were 36 subjects, 21 males and 15 females with median age of 23 (range 18–48). The mean ferritin serum was 5137.8 ± 2433.5 ng/ml while CD4, CD8, and CD4/CD8 ratio were 695.56 ± 25.17; 822.4 ± 360; and 0.95 ± 0.42, respectively. The analysis of correlation showed that there is correlation of ferritin and CD4 (r = ‒0.34, P < 0.05), ferritin and CD8 (r = 0.43, P < 0.05), and ferritin and CD4/CD8 ratio (r = 0.34, P < 0.05). Conclusion: In this study, there was a correlation between ferritin serum and CD4, CD8, and CD4/CD8 ratio. An increase of ferritin in iron overload will decrease CD4, increase CD8, and decrease CD4/CD8 ratio.

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