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Complications and treatment of patients with β-thalassemia in France: results of the National Registry

Identifieur interne : 000B44 ( Main/Exploration ); précédent : 000B43; suivant : 000B45

Complications and treatment of patients with β-thalassemia in France: results of the National Registry

Auteurs : Isabelle Thuret [France] ; Corinne Pondarré [France] ; Anderson Loundou ; Dominique Steschenko ; Robert Girot [France] ; Dora Bachir ; Christian Rose ; Vincent Barlogis [France] ; Jean Donadieu [France] ; Mariane De Montalembert [France] ; Isabelle Hagege [France] ; Brigitte Pegourie [France] ; Claire Berger ; Marguerite Micheau ; Françoise Bernaudin ; Thierry Leblanc [France] ; Laurence Lutz [France] ; Frédéric Galactéros ; Marie-Claude Siméoni ; Catherine Badens [France]

Source :

RBID : PMC:2864377

Abstract

Background

β-thalassemia is a rare disease in France, encountered mainly in patients originating from Italy and North Africa. In the setting of the recent French plan for rare diseases, a National Registry for thalassemia has been developed since 2005. Epidemiological and clinical data have been collected on living patients with β-thalassemia major or intermedia, including those who underwent hematopoietic stem cell transplantation.

Design and Methods

A standardized questionnaire was sent to clinicians throughout the national professional networks involved in the management of thalassemic patients and data were updated every 18 months. A cross-sectional study was performed in February 2009.

Results

Data on 378 patients (267 with thalassemia major) with a median age of 20 were recorded. Hematopoietic stem cell transplantation was performed in 52 patients. Stature, rates of parenthood, splenectomy, and cholecystectomy were no different between non-transplanted thalassemia major and thalassemia intermedia patients, after adjustment for age. Among the 215 non-transplanted thalassemia major patients, the median serum ferritin level was 1240 ng/mL and the rates of iron-related complications were 10%, 6%, 10% and 48% for cardiac failure, diabetes, hypothyroidism, and hypogonadism, respectively. From 2005 to 2008, a dramatic switch in chelation treatment, from deferoxamine to deferasirox, was observed.

Conclusions

The rates of complications of iron overload in French thalassemia major patients appeared similar to those reported in other developed countries in which this condition is not endemic. There were no significant differences in height and parenthood rates between patients with the major and the intermedia forms of the disease, underlining the progress in clinical care. Future developments will focus on mortality and morbidity under oral chelation treatment.


Url:
DOI: 10.3324/haematol.2009.018051
PubMed: 20007138
PubMed Central: 2864377


Affiliations:


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<name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name>
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<name sortKey="Galacteros, Frederic" sort="Galacteros, Frederic" uniqKey="Galacteros F" first="Frédéric" last="Galactéros">Frédéric Galactéros</name>
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<title xml:lang="en" level="a" type="main">Complications and treatment of patients with β-thalassemia in France: results of the National Registry</title>
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<name sortKey="Steschenko, Dominique" sort="Steschenko, Dominique" uniqKey="Steschenko D" first="Dominique" last="Steschenko">Dominique Steschenko</name>
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<name sortKey="Girot, Robert" sort="Girot, Robert" uniqKey="Girot R" first="Robert" last="Girot">Robert Girot</name>
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<name sortKey="Bachir, Dora" sort="Bachir, Dora" uniqKey="Bachir D" first="Dora" last="Bachir">Dora Bachir</name>
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<name sortKey="Rose, Christian" sort="Rose, Christian" uniqKey="Rose C" first="Christian" last="Rose">Christian Rose</name>
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<nlm:aff id="af8-0950724"> Service d’Oncologie et d’Hématologie, Hôpital St Vincent de Paul, Lille</nlm:aff>
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<name sortKey="Barlogis, Vincent" sort="Barlogis, Vincent" uniqKey="Barlogis V" first="Vincent" last="Barlogis">Vincent Barlogis</name>
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<nlm:aff id="af1-0950724"> Service d’Hématologie Pédiatrique, Hôpital d’Enfants de la Timone</nlm:aff>
<wicri:noCountry code="subfield">Hôpital d’Enfants de la Timone</wicri:noCountry>
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<nlm:aff id="af2-0950724"> Centre de Référence Maladies Rares “Thalassémies”, Hôpital d’Enfants de la Timone, Marseille</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Marseille</settlement>
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<wicri:orgArea> Centre de Référence Maladies Rares “Thalassémies”, Hôpital d’Enfants de la Timone</wicri:orgArea>
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<name sortKey="Donadieu, Jean" sort="Donadieu, Jean" uniqKey="Donadieu J" first="Jean" last="Donadieu">Jean Donadieu</name>
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<nlm:aff id="af9-0950724"> Service d’Hématologie et d’Oncologie Pédiatrique, Hôpital Trousseau, Paris</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Paris</settlement>
<region type="région" nuts="2">Île-de-France</region>
</placeName>
<wicri:orgArea> Service d’Hématologie et d’Oncologie Pédiatrique, Hôpital Trousseau</wicri:orgArea>
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<name sortKey="De Montalembert, Mariane" sort="De Montalembert, Mariane" uniqKey="De Montalembert M" first="Mariane" last="De Montalembert">Mariane De Montalembert</name>
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<nlm:aff id="af10-0950724"> Service de Pédiatrie, Hôpital Necker, Paris</nlm:aff>
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<placeName>
<settlement type="city">Paris</settlement>
<region type="région" nuts="2">Île-de-France</region>
</placeName>
<wicri:orgArea> Service de Pédiatrie, Hôpital Necker</wicri:orgArea>
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<name sortKey="Hagege, Isabelle" sort="Hagege, Isabelle" uniqKey="Hagege I" first="Isabelle" last="Hagege">Isabelle Hagege</name>
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<nlm:aff id="af11-0950724"> Service de Médecine Interne, Hôpital Tenon, Paris</nlm:aff>
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<placeName>
<settlement type="city">Paris</settlement>
<region type="région" nuts="2">Île-de-France</region>
</placeName>
<wicri:orgArea> Service de Médecine Interne, Hôpital Tenon</wicri:orgArea>
</affiliation>
</author>
<author>
<name sortKey="Pegourie, Brigitte" sort="Pegourie, Brigitte" uniqKey="Pegourie B" first="Brigitte" last="Pegourie">Brigitte Pegourie</name>
<affiliation wicri:level="3">
<nlm:aff id="af12-0950724"> Service d’Hématologie Clinique, Hôpital Michallon, Grenoble</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Grenoble</settlement>
<region type="region" nuts="2">Auvergne-Rhône-Alpes</region>
<region type="old region" nuts="2">Rhône-Alpes</region>
</placeName>
<wicri:orgArea> Service d’Hématologie Clinique, Hôpital Michallon</wicri:orgArea>
</affiliation>
</author>
<author>
<name sortKey="Berger, Claire" sort="Berger, Claire" uniqKey="Berger C" first="Claire" last="Berger">Claire Berger</name>
<affiliation>
<nlm:aff id="af13-0950724"> Service de Pédiatrie, Hôpital Nord, Saint Etienne</nlm:aff>
<wicri:noCountry code="subfield">Saint Etienne</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Micheau, Marguerite" sort="Micheau, Marguerite" uniqKey="Micheau M" first="Marguerite" last="Micheau">Marguerite Micheau</name>
<affiliation>
<nlm:aff id="af14-0950724"> Laboratoire d’Hématologie et d’Immunologie, Hôpital Pellegrin, Bordeaux</nlm:aff>
<wicri:noCountry code="subfield">Bordeaux</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Bernaudin, Francoise" sort="Bernaudin, Francoise" uniqKey="Bernaudin F" first="Françoise" last="Bernaudin">Françoise Bernaudin</name>
<affiliation>
<nlm:aff id="af15-0950724"> Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil</nlm:aff>
<wicri:noCountry code="subfield">Créteil</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name>
<affiliation wicri:level="3">
<nlm:aff id="af16-0950724"> Service d’Hématologie Pédiatrique, Hôpital Robert Debré, Paris</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Paris</settlement>
<region type="région" nuts="2">Île-de-France</region>
</placeName>
<wicri:orgArea> Service d’Hématologie Pédiatrique, Hôpital Robert Debré</wicri:orgArea>
</affiliation>
</author>
<author>
<name sortKey="Lutz, Laurence" sort="Lutz, Laurence" uniqKey="Lutz L" first="Laurence" last="Lutz">Laurence Lutz</name>
<affiliation wicri:level="3">
<nlm:aff id="af17-0950724"> Service d’Oncologie et d’Hématologie Pédiatrique, Hôpital Hautepierre, Strasbourg</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Strasbourg</settlement>
<region type="region" nuts="2">Grand Est</region>
<region type="old region" nuts="2">Alsace (région administrative)</region>
</placeName>
<wicri:orgArea> Service d’Oncologie et d’Hématologie Pédiatrique, Hôpital Hautepierre</wicri:orgArea>
</affiliation>
</author>
<author>
<name sortKey="Galacteros, Frederic" sort="Galacteros, Frederic" uniqKey="Galacteros F" first="Frédéric" last="Galactéros">Frédéric Galactéros</name>
<affiliation>
<nlm:aff id="af7-0950724"> Unité des Maladies Génétiques du Globule Rouge, Hôpital Henri Mondor, Créteil</nlm:aff>
<wicri:noCountry code="subfield">Créteil</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Simeoni, Marie Claude" sort="Simeoni, Marie Claude" uniqKey="Simeoni M" first="Marie-Claude" last="Siméoni">Marie-Claude Siméoni</name>
<affiliation>
<nlm:aff id="af4-0950724"> Unité d’Aide Méthodologique à la Recherche Clinique et Epidémiologique, Faculté de Médecine de Marseille</nlm:aff>
<wicri:noCountry code="subfield">Faculté de Médecine de Marseille</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Badens, Catherine" sort="Badens, Catherine" uniqKey="Badens C" first="Catherine" last="Badens">Catherine Badens</name>
<affiliation wicri:level="1">
<nlm:aff id="af18-0950724"> Laboratoire de Génétique Moléculaire, Hôpital d’Enfants de la Timone, Marseille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea> Laboratoire de Génétique Moléculaire, Hôpital d’Enfants de la Timone, Marseille</wicri:regionArea>
<placeName>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="af2-0950724"> Centre de Référence Maladies Rares “Thalassémies”, Hôpital d’Enfants de la Timone, Marseille</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Marseille</settlement>
<region type="région" nuts="2">Provence-Alpes-Côte d'Azur</region>
</placeName>
<wicri:orgArea> Centre de Référence Maladies Rares “Thalassémies”, Hôpital d’Enfants de la Timone</wicri:orgArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Haematologica</title>
<idno type="ISSN">0390-6078</idno>
<idno type="eISSN">1592-8721</idno>
<imprint>
<date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>β-thalassemia is a rare disease in France, encountered mainly in patients originating from Italy and North Africa. In the setting of the recent French plan for rare diseases, a National Registry for thalassemia has been developed since 2005. Epidemiological and clinical data have been collected on living patients with β-thalassemia major or intermedia, including those who underwent hematopoietic stem cell transplantation.</p>
</sec>
<sec>
<title>Design and Methods</title>
<p>A standardized questionnaire was sent to clinicians throughout the national professional networks involved in the management of thalassemic patients and data were updated every 18 months. A cross-sectional study was performed in February 2009.</p>
</sec>
<sec>
<title>Results</title>
<p>Data on 378 patients (267 with thalassemia major) with a median age of 20 were recorded. Hematopoietic stem cell transplantation was performed in 52 patients. Stature, rates of parenthood, splenectomy, and cholecystectomy were no different between non-transplanted thalassemia major and thalassemia intermedia patients, after adjustment for age. Among the 215 non-transplanted thalassemia major patients, the median serum ferritin level was 1240 ng/mL and the rates of iron-related complications were 10%, 6%, 10% and 48% for cardiac failure, diabetes, hypothyroidism, and hypogonadism, respectively. From 2005 to 2008, a dramatic switch in chelation treatment, from deferoxamine to deferasirox, was observed.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>The rates of complications of iron overload in French thalassemia major patients appeared similar to those reported in other developed countries in which this condition is not endemic. There were no significant differences in height and parenthood rates between patients with the major and the intermedia forms of the disease, underlining the progress in clinical care. Future developments will focus on mortality and morbidity under oral chelation treatment.</p>
</sec>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>France</li>
</country>
<region>
<li>Alsace (région administrative)</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Grand Est</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Rhône-Alpes</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Grenoble</li>
<li>Lyon</li>
<li>Marseille</li>
<li>Paris</li>
<li>Strasbourg</li>
</settlement>
</list>
<tree>
<noCountry>
<name sortKey="Bachir, Dora" sort="Bachir, Dora" uniqKey="Bachir D" first="Dora" last="Bachir">Dora Bachir</name>
<name sortKey="Berger, Claire" sort="Berger, Claire" uniqKey="Berger C" first="Claire" last="Berger">Claire Berger</name>
<name sortKey="Bernaudin, Francoise" sort="Bernaudin, Francoise" uniqKey="Bernaudin F" first="Françoise" last="Bernaudin">Françoise Bernaudin</name>
<name sortKey="Galacteros, Frederic" sort="Galacteros, Frederic" uniqKey="Galacteros F" first="Frédéric" last="Galactéros">Frédéric Galactéros</name>
<name sortKey="Loundou, Anderson" sort="Loundou, Anderson" uniqKey="Loundou A" first="Anderson" last="Loundou">Anderson Loundou</name>
<name sortKey="Micheau, Marguerite" sort="Micheau, Marguerite" uniqKey="Micheau M" first="Marguerite" last="Micheau">Marguerite Micheau</name>
<name sortKey="Rose, Christian" sort="Rose, Christian" uniqKey="Rose C" first="Christian" last="Rose">Christian Rose</name>
<name sortKey="Simeoni, Marie Claude" sort="Simeoni, Marie Claude" uniqKey="Simeoni M" first="Marie-Claude" last="Siméoni">Marie-Claude Siméoni</name>
<name sortKey="Steschenko, Dominique" sort="Steschenko, Dominique" uniqKey="Steschenko D" first="Dominique" last="Steschenko">Dominique Steschenko</name>
</noCountry>
<country name="France">
<region name="Provence-Alpes-Côte d'Azur">
<name sortKey="Thuret, Isabelle" sort="Thuret, Isabelle" uniqKey="Thuret I" first="Isabelle" last="Thuret">Isabelle Thuret</name>
</region>
<name sortKey="Badens, Catherine" sort="Badens, Catherine" uniqKey="Badens C" first="Catherine" last="Badens">Catherine Badens</name>
<name sortKey="Badens, Catherine" sort="Badens, Catherine" uniqKey="Badens C" first="Catherine" last="Badens">Catherine Badens</name>
<name sortKey="Barlogis, Vincent" sort="Barlogis, Vincent" uniqKey="Barlogis V" first="Vincent" last="Barlogis">Vincent Barlogis</name>
<name sortKey="De Montalembert, Mariane" sort="De Montalembert, Mariane" uniqKey="De Montalembert M" first="Mariane" last="De Montalembert">Mariane De Montalembert</name>
<name sortKey="Donadieu, Jean" sort="Donadieu, Jean" uniqKey="Donadieu J" first="Jean" last="Donadieu">Jean Donadieu</name>
<name sortKey="Girot, Robert" sort="Girot, Robert" uniqKey="Girot R" first="Robert" last="Girot">Robert Girot</name>
<name sortKey="Hagege, Isabelle" sort="Hagege, Isabelle" uniqKey="Hagege I" first="Isabelle" last="Hagege">Isabelle Hagege</name>
<name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name>
<name sortKey="Lutz, Laurence" sort="Lutz, Laurence" uniqKey="Lutz L" first="Laurence" last="Lutz">Laurence Lutz</name>
<name sortKey="Pegourie, Brigitte" sort="Pegourie, Brigitte" uniqKey="Pegourie B" first="Brigitte" last="Pegourie">Brigitte Pegourie</name>
<name sortKey="Pondarre, Corinne" sort="Pondarre, Corinne" uniqKey="Pondarre C" first="Corinne" last="Pondarré">Corinne Pondarré</name>
<name sortKey="Pondarre, Corinne" sort="Pondarre, Corinne" uniqKey="Pondarre C" first="Corinne" last="Pondarré">Corinne Pondarré</name>
</country>
</tree>
</affiliations>
</record>

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