Impact of Splenectomy on Natural Killer and T Lymphocyte Levels in Pediatric Transfusion-Dependent β-Thalassemia Major

Document Type : New and original researches in the field of Microbiology.

Authors

1 Clinical Pathology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt

2 Pediatrics Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt

Abstract

Background: In transfusion-dependent β-thalassemia major (β-TM), repeated transfusions lead to iron overload and immune system compromise. Splenectomy further weaken immunity, increasing infection risk. Objectives: To investigate the impact of splenectomy on T lymphocyte and natural killer (NK) levels in pediatric patients with transfusion-dependent (β-TM). Methodology: Fifty-one β-TM patients were studied (35 non-splenectomized and16 splenectomized). Blood count, Serum ferritin, CD3+ T lymphocyte, and CD3−/CD16+CD56+ NK cell were measured. Results: Splenectomized patients had significantly higher hemoglobin, White blood cell, neutrophils, and lymphocytes counts (P = 0.0007, 0.047, 0.0001, and 0.031, respectively). However, they showed significantly lower NK and T cell levels (P = 0.031 and 0.011). No significant differences were seen in ferritin levels, transfusion frequency, or chelation therapy. The splenectomized group had a higher average age and more cardiovascular complications. A negative correlation between ferritin and NK cells in the non-splenectomized group (P = 0.014), while in the splenectomized group, ferritin negatively correlated with CD3+ T cells (P = 0.036). Conclusion: Splenectomy improve anemia in β-TM patients but does not lower iron over load or transfusion needs. It is associated with reduced NK and T lymphocyte levels, indicating impaired immune function.

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