Immune Response of Thalassemia Major Patients in Indonesia with and without Splenectomy
ABSTRACT: to describe
non-spesifc and specifc immune response profle in Indonesian thalassemia major
with and without splenectomy. Methods: this study was held at Thalassaemia
Centre, Cipto Mangunkusumo Hospital Jakarta on September 2013 – February 2014.
A comparative cross sectional study was conducted in healthy, thalassemia major
aged more than 12 year and seronegative HIV. They were matched in age and sex
for splenectomised and non-splenectomised groups, analysing the non-spesifc
immune response (neutrophil count and phagocytosis) and specifc immune response
(count and function of cellular immunity). Infection episodes were also
analized as immune response in vivo parameter. Results: splenectomised
thalassemia major showed increased neutrophil count but signifcantly decreased
non-spesifc immune response (neutrophil phagocytosis). Spesifc immune response
of splenectomised group presented signifcantly higher absolute lymphocyte,
lymphocyte T, CD4+ and CD8+ counts compared to non-splenectomised thalassemia
major (p<0.05). Ratio CD4+/CD8+ were similar in these groups. Serum marker
of activated cellular imunity function (IL-2 and TNF-α) were similar among two
groups. Mild infection episodes on splenectomised and non-splenectomised group
were 2.02 (ranged 0 to 12) times and 0.81 (ranged 0 to 8) times (p=0.004),
respectively. Severe infection on splenectomised group were sepsis for 2 weeks and
diarrhea for 1 week, whereas on non-splenectomised group was typhoid fever for
4 days. Conclusion: there were signifcant differences on immune response among
thalassemia major patients. Splenectomised thalassemia major showed a greater
degree of susceptibility to infections than non-splenectomised thalassemia
major.
Author: Teny T. Sari,
Djajadiman Gatot, Arwin A.P. Akib, Saptawati Bardosono, Sri R.S. Hadinegoro,
Alida R. Harahap, Ponpon S. Idjradinata
Journal Code: jpkedokterangg140284