Effect of iron therapy on red cell indices and hemoglobin subtypes on patients with beta-thalassemia trait who developed iron-deficiency anemia: a tertiary center experience

Background The combination of beta-thalassemia trait (BTT) and iron-deficiency anemia (IDA) is an interesting common issue in our country. However, treatment of this condition is challenging. Objectives This prospective observational study was designed to evaluate the effect of oral iron therapy on red cell indices, iron status, and hemoglobin A 2 levels in patients with BTT who developed IDA. Patients and methods A total of 50 patients with BTT who developed IDA were included. A complete blood count, iron status, and follow-up hemoglobin electrophoresis by high-performance liquid chromatography were done. The patients with BTT received oral iron therapy of 60mg elemental iron three times/day for a period of 5 months, and the investigations were repeated after 3 and 5 months of treatment. Results There was a statistically significant increase in hemoglobin level ( P <0.001 each), mean corpuscular volume ( P <0.001 each), mean corpuscular hemoglobin ( P =0.004 and P <0.001, respectively), mean corpuscular hemoglobin concentration ( P =0.007 and P =0.001, respectively), serum iron ( P <0.001 each), serum ferritin ( P <0.001 each), and hemoglobin A 2 levels ( P =0.001 and P =0.005, respectively), whereas significant decrease in the total iron-binding capacity ( P =0.001, and P =0.005, respectively) after the third and fifth month of oral iron therapy. Conclusion It is important to suspect, recognize, and correct IDA in patients with BTT and to repeat hemoglobin electrophoresis after iron therapy.