Evaluation of Inflammatory Biomarkers and Oxidative Stress Parameters Before and After Low-Dose Thalidomide Therapy in Patients with β-Thalassemia
Keywords:
β-Thalassemia; Thalidomide; Oxidative stress; Inflammatory biomarkers; C-reactive protein; Interleukin-6.Abstract
Background: β-Thalassemia is a hereditary hemoglobinopathy characterized by ineffective erythropoiesis, chronic hemolytic anemia,
iron overload, oxidative stress, and persistent inflammation. Increased production of reactive oxygen species and elevated inflammatory
cytokines contribute significantly to disease progression and multiple organ complications. Low-dose thalidomide has emerged as
a promising therapeutic option due to its ability to induce fetal hemoglobin production, improve erythropoiesis, reduce transfusion
requirements, and exert anti-inflammatory effects. However, limited data are available regarding its influence on inflammatory
biomarkers and oxidative stress parameters in patients with β-thalassemia.
Objective: To evaluate changes in inflammatory biomarkers and oxidative stress parameters before and after low-dose thalidomide
therapy in patients with β-thalassemia.
Materials and Methods: A retrospective observational study was conducted in the Department of Clinical Hematology, S.C.B. Medical
College and Hospital, Cuttack, Odisha, India, from September 2025 to June 2026. Medical records of patients with β-thalassemia
receiving low-dose thalidomide therapy were reviewed. Demographic characteristics, clinical features, hematological parameters,
inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and oxidative
stress markers including malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), and total antioxidant
capacity (TAC) were collected before initiation of therapy and after six months of treatment. Statistical analysis was performed using
SPSS version 26.0. Continuous variables were expressed as mean ± standard deviation and compared using paired Student’s t-test.
A p-value <0.05 was considered statistically significant.
Results: Following six months of low-dose thalidomide therapy, significant reductions were observed in serum CRP, IL-6, TNF-α,
and MDA levels (all p<0.001). Antioxidant parameters including SOD, GPx, and TAC showed significant improvement after treatment
(p<0.001). Mean hemoglobin concentration increased significantly, while annual transfusion requirements decreased. No serious
adverse events requiring permanent discontinuation of therapy were observed.
Conclusion: Low-dose thalidomide significantly reduced systemic inflammation and oxidative stress while improving antioxidant
defense and hematological parameters in patients with β-thalassemia. These findings support its potential role as an effective adjunctive
therapy in the management of transfusion-dependent β-thalassemia.
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