Iron Chelation, Vitamins, and Supplements for Thalassemia Patients: Scoping Review
DOI:
https://doi.org/10.37287/ijghr.v8i4.2179Keywords:
bone mineral density, iron chelation therapy, thalassemia, oxidative stressAbstract
Thalassemia major and transfusion-dependent thalassemia (TDT) are hereditary hemoglobinopathies that require lifelong blood transfusions and iron chelation therapy to prevent complications related to iron overload. Despite advances in chelation therapy, patients continue to experience complications such as oxidative stress, endocrine disorders, and bone health deterioration. This scoping review aimed to synthesize evidence from research articles regarding the role of iron chelation agents, including deferoxamine (DFO), deferiprone (DFP), and deferasirox (DFX), together with vitamin and supplement interventions in the management of thalassemia patients. This study used the PRISMA-ScR guidelines to identify scientific articles published between 2016 and 2025 from the PubMed and Scopus databases. Eligible studies were selected through title, abstract, and full-text screening according to predefined inclusion and exclusion criteria. Data were extracted, categorized by intervention type, and synthesized descriptively to examine the role of iron chelation therapy, vitamin C, vitamin D, vitamin E, folic acid, calcium, and antioxidant supplements in thalassemia management. A total of 29 articles met the inclusion criteria and were reviewed. The main findings demonstrated that vitamin C enhances the effectiveness of iron chelation therapy, particularly when combined with DFO. Vitamin D and calcium supplementation improve bone mineral density and reduce the risk of osteoporosis. Vitamin E and other antioxidants help reduce oxidative stress, while appropriate folic acid supplementation prevents deficiency without causing excessive accumulation. The combination of iron chelation therapy with vitamins and supplements provides benefits in reducing complications associated with iron overload, improving bone health, and decreasing oxidative stress in patients with thalassemia. This review offers evidence-based insights to optimize nutritional management in patients with thalassemia undergoing iron chelation therapy.
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