Comparison of vascular complications between conventional treatment and bone marrow transplantation for children with ß-thalassemia disease

Patients with ß-thalassemia may be predisposed to premature atherosclerosis due to vascular dysfunction. This is observed in adults. Whether atherosclerosis changes in ß-thalassemia disease (BTD) occur early in childhood is not clear. To prevent cardiovascular complications, this needs evaluation. Moreover, it remains uncertain whether curative treatment with bone marrow transplantation (BMT) would improve this vascular alteration. For this study, 37 ß-thalassemia children age 10.1 ± 2.7 years were classified into group 1 (25 children with BTD treated conventionally) and group 2 (12 children with BTD who underwent BMT). A control group of 29 age-matched healthy children were studied simultaneously. The carotid stiffness index and intima-media thickness (IMT) were measured. Group1 had a greater arterial stiffness index than the control subjects (4.57 ± 1.78 vs. 2.87 ± 1.07; p < 0.001). The carotid IMT was significantly greater in both BTD groups than in the control group (group 1: 0.45 ± 0.03 vs. 0.34 ± 0.04 mm; p < 0.001; group 2: 0.43 ± 0.03 vs. 0.34 ± 0.04 mm; p < 0.001). Carotid IMT and arterial stiffness are increased in conventionally treated children with ß-thalassemia, suggesting an early atherosclerotic change in these children, whereas children with BTD who underwent BMT had an increased carotid IMT but normal arterial stiffness.