Investigating the prolongation of blood transfusion frequency in thalassemic children by omega 3 fatty acid and protein supplementations through milk
Background: Thalassemia is an inherited genetic hemoglobin disorder wherein, afflicted child is born when both parents are carriers for defective alpha or beta hemoglobin gene. The thalassemias are the most common genetic disorder on a worldwide basis. The requirement of frequent blood transfusions in these patients pose a substantial burden on the health care system.
Methods: A prospective observational study was conducted across 6 months (July 2018-December 2018) in a tertiary care hospital, Pune. The present study included 30 registered patient & their past 6 months record of blood transfusion (esp frequency), previous hemoglobin levels, height & weight. All these parameters were compared 6 months after supplementation with Omega 3 fatty Acids & proteins.
Results: Total 16 of 28 patient showed that the average durations between two blood transfusions was increased by minimum 01 day to a maximum of 5 days. The average number of blood bag required was less than required blood bags in the period of pre supplementation. 20 of 28 patients showed a rise in hemoglobin level from a range of 0.5 to 1.2 gm/dl.
Conclusions: In a country like India, with the high frequency of hemoglobinopathies, causing increased burden on the society, it is necessary to control the incidence by effective steps. Low cost and easily administered supplementation by omega 3 fatty acid and proteins may reduce the requirement of repeated blood transfusion along with increase in hemoglobin level. Implementation of carrier screening program offering genetic counseling and prenatal diagnosis followed by selective termination of affected cases would help in preventing the disease.
Borgna-Pignatti C, Cappellini MD, De Stefano P, Del Vecchio GC, Forni GL, Gamberini MR, et al. Survival and complications in thalassemia. Ann N Y Acad Sci. 2005;1054:40-7.
Katz EA. Blood transfusion: Friend or foe. AACN Adv Crit Care. 2009;20:155-63.
Shah N, Mishra A, Chauhan D, Vora C. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in Western India. Asian J Transfus Sci.2010;4:94-8.
Bertrand Fougere, Sabine Goisser, Christelle Cantet, et all. Omega-3 fatty acid levels in red blood cell membranes and physical decline over 3 years. Springer Gero Science. 2017;39(4):429-37.
Beshlawy A, Kaddah N, Moustafa A, Mouktar G, Youssry I. Screening for P- thalassemia carriers in Egypt: Significance of the osmotic fragility test. East Mediterr Health J. 2007;13:780-6
Cario H, Stahnke K, Kohne E. Beta-thalassemia in Germany. Results of cooperative beta-thalassemia study. Klin Padiatr. 1999;211:431-7.
Rebulla P. Transfusion reactions in thalassemia. A survey from the Cooley care. The Cooley Care Cooperative Group. Haematologica. 1990;75:122-7.
Climent-Peris C, Velez-Rosario R. Immediate transfusion reactions. P.R. Health Sci J. 2001;20:229-35.
Madan N, Sharma S, Sood SK, Colah R, Bhatia HM. Frequency of β-thalassemia trait and other hemoglobinopathies in northern and western India. Ind J Hum Genet. 2010;16(1):16.
Colah R, Italia K, Gorakshakar A. Burden of thalassemia in India: The road map for control. Pediat Hematol Oncol J. 2017;2(4):79-84.
Sherief LM, El-Salam A, Sanaa M, Kamal NM, Almalky MA, Azab SF, et al. Nutritional biomarkers in children and adolescents with beta-thalassemia-major: an Egyptian center experience. Bio Med Res Int. 2014;2014.
Abdulrazzaq YM, Ilbrahim A, AI-Khayat AI, Dawson K. "Beta thalassemia major and its effect on amino acid metabolism and growth in patient in the United Arab Emirates" Clin Chim Acta. 2005;352(1-2):183-90.
Thongkijpreecha P, Kangsadalampai O, Pongtanakul B, Meksawan K. Nutritional Status in Patients with Thalassemia Intermedia. J Hematol Transfus Med 2011;21:167-76.
Fuchs GJ, Tienboon P, Khaled MA, Nimsakul S, Linpisarn S, Faruque AS, et al. Nutritional support and growth in thalassaemia major. Arch Disea Childhood. 1997;76(6):509-12.