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Ann Hematol ; 100(4): 921-931, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33586016

RESUMO

Alpha thalassemia and beta-globin haplotype are considered classical genetic disease modifiers in sickle cell anemia (SCA) causing clinical heterogeneity. Nevertheless, their functional impact on SCA disease emergence and progression remains elusive. To better understand the role of alpha thalassemia and beta-globin haplotype in SCA, we performed a retrospective study evaluating the clinical manifestations of 614 patients. The univariate analysis showed that the presence of alpha-thalassemia -3.7-kb mutation (αα/-α and -α/-α) decreased the risk of stroke development (p = 0.046), priapism (p = 0.033), and cholelithiasis (p = 0.021). Furthermore, the cumulative incidence of stroke (p = 0.023) and cholelithiasis (p = 0.006) was also significantly lower for patients carrying the alpha thalassemia -3.7-kb mutation. No clinical effects were associated with the beta-globin haplotype analysis, which could be explained by the relatively homogeneous haplotype composition in our cohort. Our results reinforce that alpha thalassemia can provide protective functions against hemolysis-related symptoms in SCA. Although, several genetic modifiers can impact the inflammatory state of SCA patients, the alpha thalassemia mutation remains one of the most recurrent genetic aberration and should therefore always be considered first.


Assuntos
Anemia Falciforme/complicações , Talassemia alfa/complicações , Globinas beta/genética , Adolescente , Adulto , Idoso , Anemia Falciforme/sangue , Anemia Falciforme/genética , Arteriopatias Oclusivas/epidemiologia , Arteriopatias Oclusivas/etiologia , Brasil/epidemiologia , Criança , Colelitíase/epidemiologia , Colelitíase/etiologia , Feminino , Hemoglobina Fetal/análise , Seguimentos , Haplótipos/genética , Hemólise , Humanos , Úlcera da Perna/epidemiologia , Úlcera da Perna/etiologia , Masculino , Mutação , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Resultado do Tratamento , Adulto Jovem , Talassemia alfa/sangue , Talassemia alfa/genética
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