Plasma Zinc Difference in Children with Thalassemia β Major Received Deferiprone or Deferasirox Zinc


  • Wahyu Kusumawardhani Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta
  • Harsono Salimo Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta
  • Muhamad Riza Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital, Surakarta


Background: Thalassemia is a blood disease charac­­terized by the most frequently found auto­somal recessive hereditary hemolytic anemia. It requires repeated blood trans­fusions for life. Routine blood transfusion can cause complica­tions in the form of accumu­lation of ferritin in the tissue. Iron chelation therapy is considered effective for treating body iron deposits. How­ever, iron chelation therapy has the side effect of decreasing levels of other im­­­­portant minerals such as zinc (Zn). This study aimed to examine plasma zinc difference in children with Thalasse­mia β major received deferiprone or deferasirox zinc.

Subjects and Method: This was a cross sec­tional study conducted at Dr. Moewardi Hospital, Surakarta, from February to April 2017. A sample of 40 children with thalassemia β major aged 3 to 18 years who received deferiprone iron chelation and defe­rasirox at least 6 months was selected by consecutive sampling. The dependent variable was serum zinc levels. The independent vari­ables were iron ­deferip­rone and deferasirox. Plasma zinc levels were measured by atomic absorption spectroscope. The data were analyzed by t test.

Results: Zinc levels in patients with deferiprone therapy (Mean= 54.50; SD= 11.02) were lower than defera­sirox therapy (Mean= 60.95; SD= 20.71), but statistically not significant (p= 0.229).

Conclusion:Zinc levels in patients with deferi­prone therapy are lower than deferasirox therapy, but not statistically significant.

Keywords: zinc, deferiprone, deferasirox, children with thalassemia β major

Correspondence: Wahyu Kusumawardhani. Department of Pedi­a­trics, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Cen­tral Java. Phone/ Fax: 0271-633348. Email: dha­nisurya­diraja­

Indonesian Journal of Medicine (2020), 05(02): 102-108


Hagag AA, Elfaragy MS, Elrifaey SM, Abd ElLateef AE (2015). Therapeutic value of combined therapy with deferiprone and silymarinas iron chelators in Egyptian children with beta thalassemia major. Infect Disord Drug Targets, 15(3): 189 – 195.

Al-Kloub MI, A Bed MA, Al Khawaldeh OA, Al Tawarah YM, Froelicher ES (2014). Predictors of non-adherence to followup visits and deferasirox chelation therapy among Jordanian adolescents with thalassemia major. Pediatr Hematol Oncol, 31(7): 624–637.

Chuansumrit A, Pengpis P, Mahachoklertwattana P, Sirachainan N, Poomthavorn P, Sungkarat W, Kadegasem P, Khlairit P, Wongwerawattanakoon P (2016). Effect of iron chelation therapy on glucose metabolism in non-transfusion dependent thalassaemia. Acta Haematol, 137(1): 20–26.

Fung EB (2016). The importance of nutrition for health in patients with transfusiondependent thalassemia. Ann Ny Acad Sci, 1368(1): 40–48.

Gomber S, Dabas A, Bagmar S, Madhu SV (2017). Glucose homeostasis and effect of chelation on β cell function in children with β-Thalassemia major. J Pediatr Hematol Oncol. 40(1):56-59.

Jensen PD (2002). Relationship between hepatocellular injury and transfusional iron overload prior to and during iron chelation with desferrioxamine: a study in adult patients with acquired anemias. Bld, 101(1): 91–96.

Kizilgun M, Takci S, Erkekoglu P, Asci A, Balci A, Yigit S, Kocer-Gumusel B (2016). Copper, zinc and iron levels in premature infants following red blood cell transfusion. J Trace Elem Med Bio, 38: 126–130.

Kulathinal S, Freese R, Korkalo L, Ismael C, Mutanen M (2016). Mid-upper arm circumference is associated with biochemically determined nutritional status indicators among adolescent girls in Central Mozambique. Nutr Res Rev, 36(8): 835–844.

LachowiczJI, NurchiVM, Crisponi G, Jaraquemada-Pelaez MG, Ostrowska M, Jezierska J, Gumienna-Kontecka E, et al. (2015). Zinc(II) and copper(II) complexes with hydroxypyrone iron chelators. J Inorg Biochem, 151: 94–106.

Vosper J, Evangeli M, Porter JB, Shah F (2018). Psychological Factors Associated with Episodic Chelation Adherence in Thalassemia. Hb, 42(1): 30–36.

Zekavat OR, Bahmanjahromi A, Haghpanah S, Ebrahimi S, Cohan N (2018). The Zinc and Copper Levels in Thalassemia Major Patients, Receiving Iron Chelation Therapy. J Pediatr Hematol Oncol. 40(3): 178–181.