Effects of Vitamin E on Transfusion Requirements in TransfusionDependent Beta-Thalassemia Patients

Abstract

Objective: To evaluate the volume of blood transfusion requirements as well as hemolytic and oxidative biochemical variables in transfusion-dependent β-thalassemia patients supplemented with vitamin E. Material and Methods: A prospective, double-blind, randomized, placebo-controlled, crossover study was undertaken between December, 2012 and September, 2014 in the Pediatric Clinic of Songklanagarind Hospital. The participants were β-thalassemia major and Hb E/β-thalassemia patients aged between 5 and 18 years. A random allocation sequence was generated to receiving either 6 months of vitamin E or placebo followed by a 3-month washout period and then switching to another drug for 6 months. The outcome variable measurements were the volumes of the transfused packed red cells, and the hemolytic and oxidative biochemical variables. Results: Thirty-nine patients were enrolled into the study. All of them had significantly low levels of vitamin E and reduced glutathione levels, as well as high levels of oxidative stress shown by significantly high levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase. The vitamin E levels became normal after the 6-month period of 200-400 milligram per day of oral vitamin E intake. All of the measured oxidative stress parameters did not improve except for the glutathione peroxidase level. Moreover, there was no difference in the volumes of transfused packed red cell requirements as well as hemolytic parameters like aspartate transaminase, lactate dehydrogenase, reticulocyte count and total bilirubin levels. Finally, no adverse reactions to oral vitamin E were found. Conclusion: Vitamin E supplementation normalized the vitamin E level and possibly partially reduced oxidative stress, but there was no difference in the volume of transfusion requirements or the hemolytic parameters in transfusion-dependent β-thalassemia patients.

Keywords

• antioxidant
• blood transfusion
• hemoglobin
• oxidative stress
• thalassemia
• vitamin e