PB0248 - Prevalence of iron deficiency anemia in children with hemophilia

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Sophie Zarb, BHSc

Student
McMaster University
Toronto, Ontario, Canada

Co-Author(s)

MB

Mihir D. Bhatt, MD

Pediatric Hematologist
McMaster Children’s Hospital
Hamilton, Ontario, Canada
KD

Kay Decker

RN
Hamilton Health Scienes
Hamilton, Ontario, Canada
JE

Joycelyne Ewusie

Health Research Methodologist
McMaster University
Hamilton, Ontario, Canada
Anthony K. Chan, MBBS, FRCP (C), MBBS

Pediatric Hematologist
Department of Pediatrics, McMaster Children's Hospital
Hamilton, Ontario, Canada

Background: Prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in children is 16-20% and 3-5%, respectively. While several risk factors have been associated with increased risk, prevalence of ID/IDA has not been studied in children with hemophilia.

Aims: To determine prevalence of ID/IDA in children with hemophilia and analyze whether hemophilia type/severity or bleeding frequency are associated with increased risk.

Methods: Retrospective chart review of children ( < 18 years) with hemophilia from 2016-2021. Data collection included: demographics, hemophilia type/severity, annualized bleeding rate (ABR), and bloodwork for ID/IDA. Ferritin < 30µg/L was classified as ID and < 15µg/L as severe ID. Unadjusted and adjusted odds ratios with 95%CI were calculated for predictors using generalized linear-mixed model.

Results: Among 90 patients included, 73(81.1%) had hemophilia A and 17(18.9%) hemophilia B. Severity was mild in 33(36.7%), moderate in 8(8.9%), and severe in 49(54.4%). Ferritin was checked in 76(84.4%) patients. Among these, 62(81.6%) and 56(73.7%) had ID and IDA, respectively, after median follow-up of 4 years (range:1-14 years). Prevalence of severe ID and IDA was 36(47.4%) and 30(39.5%), respectively. For ID, age < 6 years (OR 3.83, 95%CI 1.88-7.82) was associated with higher prevalence in unadjusted and adjusted analysis (Fig.1). Hemophilia type/severity and preceding year ABR were not associated with ID. For IDA, age < 6 years (OR 33.52, 95%CI 10.09->99.9), age 6- < 12 years (OR 4.69, 95%CI 1.50-14.68), and ABR in preceding year (OR 1.41, 95%CI 1.15-1.73) were associated with higher prevalence in unadjusted analysis, while only age remained significant in the adjusted analysis (Table.1). Hemophilia type/severity were not associated with IDA.

Conclusion(s): Prevalence of ID/IDA is increased in children with hemophilia. Younger age and ABR are associated with increased risk. Further prospective studies are required to validate these findings and determine whether screening for ID/IDA would be helpful in some or all children with hemophilia.