Syma Ghayas

Hamdard University
Pakistan

Abstract Title:

Management of Iron Overload in Transfusion-Dependent ?-Thalassemia: Comparative Effects of Polyherbal Iron Chelation and Deferoxamine

Research Interests:

This randomized controlled clinical trial was conducted to evaluate the safety and efficacy of a coded polyherbal Unani formulation for the management of iron overload (IOL) in transfusion-dependent β-thalassemia patients compared with Deferoxamine (DFO). The study included 132 previously diagnosed transfusion-dependent thalassemia patients of both genders aged 10–16 years, randomly allocated into test and control groups (n=66 each). The study was conducted at Hamdard Matab, Araam Bagh, and Hussaini Blood Bank. Data were collected using a Clinical Record Form (CRF) and analyzed using SPSS version 23. The polyherbal formulation was administered orally at a dose of 500 mg twice daily with lukewarm milk, while DFO was administered subcutaneously at 40–60 mg/kg body weight for 8–12 hours daily using a portable infusion device. Baseline assessment included age, gender, and temperament evaluation. Laboratory investigations included complete blood count (CBC) and iron profile parameters. After three months of treatment, significant improvement was observed in hematological parameters in the test group. RBC count increased from 3.27 ± 0.549 to 3.67 ± 0.533 ×10^6/µL (p<0.000), whereas the control group showed no significant change (p<0.321). Hemoglobin levels in the test group improved from 8.04 ± 0.709 g/dL to 9.59 ± 1.124 g/dL (p<0.000), while control group showed insignificant difference (p<0.121). Improvements in WBC and platelet counts were also observed. Significant reduction in serum ferritin levels was noted in the test group, decreasing from 6133.98 ± 2906.506 ng/mL at baseline to 4084.19 ± 2334.710 ng/mL after treatment (p<0.001). In contrast, serum ferritin levels increased in the control group from 5056.12 ± 2359.235 ng/mL to 6354.62 ± 3002.043 ng/mL (p=0.006). Pearson correlation and linear regression analyses demonstrated a positive correlation between dominant body temperament and serum ferritin levels before and after treatment. The polyherbal Unani formulation demonstrated significant improvement in hematological and iron profile parameters with good tolerability compared with Deferoxamine. These findings suggest its potential as a cost-effective adjunct or alternative approach for the management of iron overload in transfusion-dependent β-thalassemia