Abstract

LIVER TRANSAMINASES LEVELS POST DEFERASIROX TREATMENT IN ?-THALASSEMIA MAJOR CHILDREN IN WESTERN MAHARASHTRA

Pravin D. Dhote*, Rajib Chatterjee and Jayashree Jadhav

ABSTRACT

Objectives: This study was done to determine the extent of the effect of deferasirox therapy on liver transaminases levels in β-thalassemia major patients presenting to our setup. Material and Methods: It was a retrospective longitudinal observational study conducted at Pravara Rural Hospital, Ahmednagar, in November 2021. Thirty-five patients with β -thalassemia major were included in the study. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured on admission. The previous one-year record was obtained from the central pac system of the hospital. In addition, the patient taking deferasirox at 30 mg /kg/day dose were included whose previous record was available and were continuously on deferasirox therapy. Results: In comparison to mean baseline ALT values, there were significantly elevated mean ALT values after Deferasirox therapy. There was nearly eleven times relative risk of having ALT ≥ 5 upper normal levels (UNL) in a patient with abnormal baseline ALT (Odd ratio 10.96,95% Confidence Interval: lower 2.05, upper 58.58). During a year of study, Deferasirox therapy was associated with ALT readings of ≥ 5UNL in 22(31%) of pediatric β-thalassemia patients and that elevation lasted for four weeks in 95.5% of patients. Conclusions: Elevated ALT of ≥ 5UNL after Deferasirox therapy was short-lived and lasted for four weeks in 95.5% of patients. It is advisable to start Deferasirox therapy at a dose of 30 mg /kg/day when the baseline ALT level is normal.

Keywords: Thalassemia, Deferasirox, liver transaminases, ALT, AST.