Current growth patterns in children and adolescents with thalassemia major

Although the cause of short stature in children with thalassemia major is not well understood, it is believed to be multifactorial.1 Many different factors including iron overload, intensive use of iron chelators, and gonadal damage may interact, making it difficult to understand each factor's relative contribution.2-8 It is noteworthy that short stature related to thalassemia major has been found to persist despite major advances in the treatment.1,9 In this study, we evaluated the growth patterns of 245 children and adolescents with thalassemia major (129 males) who were born between 1970 and 2011 and were under regular observation and treatment at the Ospedale Microcitemico, Cagliari, Italy. In particular, we investigated whether changes that have profoundly modified the course of this disease during recent decades (particularly in relation to the advent of oral iron chelators) have also had an effect on the prevalence of short stature. We also assessed whether the prevalence of iron complications in the pediatric stage had changed over time.