IRON-RELATED DISTURBANCES OF CELL-MEDIATED-IMMUNITY IN MULTITRANSFUSED CHILDREN WITH THALASSEMIA MAJOR

  • 1 April 1987
    • journal article
    • research article
    • Vol. 68  (1) , 138-145
Abstract
Immunological abnormalities have been observed in many haemophiliacs receiving clotting factor concentrates. To determine whether similar changes also occur after repeated blood transfusions we estimated T cell subsets and cutaneous delayed hypersensitivity (CDH) in 50 multitransfused children with .beta.-thalassemia major (.beta.-TM). All patients were also tested for anti-HTLV-III/LAV antibodies. A diminished percentage of T lymphocytes (E-rosettes, T3+), and T4+ cells and a low T4/T8 ratio was found in patients as compared to age and sex matched controls (P < 0.001). Negative CDH tests to specific antigens (Multi-test) were also found in a significantly larger proportion of .beta.-TM children (P < 0.01). Antibodies against HTLV-III/LAV were negative in all patients. Decreased T4/T8 ratio in .beta.-TM children was primarily due to a reduction of T4+ cells and was inversely correlated to the patients'' age, number of units of transfused blood (P < 0.05) and especially to ferritin serum levels and annual iron balance (P < 0.001). These findings indicate that immunological abnormalities in .beta.-TM patients appear to be acquired, transfusion-associated and related to iron load which depends on the appropriate chelation therapy.