Immune Response of Thalassemia Major Patients in Indonesia with and without Splenectomy
Abstract: to describe
non-spesific and specific immune response profile 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-spesific immune response (neutrophil count and phagocytosis)
and specific 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
significantly decreased non-spesific immune response (neutrophil phagocytosis).
Spesific immune response of splenectomised group presented significantly 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 significant
differences on immune response among thalassemia major patients. Splenectomised
thalassemia major showed a greater degree of susceptibility to infections than
non-splenectomised thalassemia major.
Key words: immune response, thalassemia
major, splenectomy
Author: Teny T Sari1,
Djajadiman Gatot, Arwin A.P. Akib, Saptawati Bardosono, Sri R.S. Hadinegoro,
Alida R Harahap, Ponpon S Idjradinata
Journal Code: jpkedokterangg140324
