Sonoclot Versus conventional coagulation parameter for assessment of hemostasic abnormalities in children with β- Thalassemia: Egyptian center study

Abstract

Background: This study assessed the efficiency of the Sonoclot analyzer and conventional hemostatic parameters in determining the hemostatic status of children with β-thalassemia Major (BTM) who had experienced bleeding or thromboembolic episodes in the past, as well as any potential underlying risk factors. Methods: Prospective cross-sectional study on 98 children with BTM. Patients are classified into three groups according to the history; bleeders group, thrombotic group and non-complicated group . Coagulation screen, D-dimer, protein C (PC), antithrombin III, ferritin, platelet aggregation response to ADP and arachidonic acid (AA), Sonoclot analysis, CD41 and CD62p by flow cytometry were performed. Results: Five patients (4.9%) had thrombosis and 15(15.3%) had bleeding. Significant higher ferritin, and Clot Rate (CR) were found in thrombotic group compared to non-complicated (P=0.04) and bleeder (P= 0.01) groups. Platelet Function was significantly lower in bleeders compared to non-complicated (P =0.00006) and thrombotic (P=0.002)groups. Protein C, PT, PC, APTT, fibrinogen, D-dimer, and ATIII, showed no significant difference between groups. Although, CD62p expression by flow cytometry showed no significant difference between groups. CR has shown a statistically significant negative correlation with PC and D-dimer. Also, significant positive correlation between platelet function by Sonoclot with ADP & AA by aggregometer. Conclusion: Sonoclot analysis may verify as an effective method for evaluating the hemostasis in children with BTM. CR and PF may become a possible future predictors of hyper and hypo -coagulability respectively. Traditional test of coagulation should be used in conjunction with the standard tests to define the hemostatic profile in those patient. Trial registration The study is approved by Assiut University's Ethical Committee of Faculty of Medicine (IRB No: 17200439)