Thalassemia and hepatocellular carcinoma: links and risks

Abstract

Maria Marsella,1 Paolo Ricchi2 1Department of Woman and Child, Pediatric Unit, San Giuseppe Moscati Hospital, Avellino, Italy; 2Unità Operativa Semplice Dipartimentale (UOSD) Malattie Rare Del Globulo Rosso, Dipartimento di oncoematologia, Azienda Ospedaliera Di Rilievo Nazionale “A. Cardarelli”, Napoli, ItalyCorrespondence: Paolo RicchiUnità Operativa Semplice Dipartimentale (UOSD), Malattie Rare Del Globulo Rosso, Dipartimento di Oncoematologia, Azienda Ospedaliera Di Rilievo Nazionale “A. Cardarelli”, Via A. Cardarelli 9, Napoli 80131, ItalyTel [phone]Fax [phone]Email [email protected]: The increased survival and lifespan of thalassemia patients, in the setting of better iron overload monitoring and chelation, have also however increased the incidence of diseases and complications, which were less likely to develop. Among these, one of the most worrying in recent years is hepatocellular carcinoma (HCC). Due to blood transfusions, many patients with thalassemia are or have been infected with hepatitis C virus (HCV) or hepatitis B virus (HBV), especially those born before the 1990s or in countries in which universal HBV vaccination and safe blood programs are still not completely implemented. However, HCC has also been described in nontransfused patients and in those who are HCV- and HBV-negative. Therefore, other risk factors are involved in hepatocarcinogenesis in thalassemia. The following review analyzes recent literature on the role of different risk factors in the progression of liver disease in thalassemia as well as the importance of surveillance. Treatment of HCC in thalassemia is still highly debated and requires further studies.Keywords: hepatocellular carcinoma, thalassemia, risk factor

Keywords

• Hepatocellular carcinoma
• thalassemia
• risk factor