Evaluation of Alpha-Thalassemia Mutations in Cases with Hypochromic Microcytic Anemia: The İstanbul Perspective.

Karakaş Z., Koç B. Ş., Temurhan S., Elgün T., Karaman S., Asker G., ...More

Turkish journal of haematology : official journal of Turkish Society of Haematology, vol.32, no.4, pp.344-50, 2015 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 4
  • Publication Date: 2015
  • Doi Number: 10.4274/tjh.2014.0204
  • Journal Name: Turkish journal of haematology : official journal of Turkish Society of Haematology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.344-50
  • Keywords: Anemia, Alpha thalassemia, Hb Adana, Hb Icaria, Hb Koya Dora, Mutation, Thalassemia, HB-H DISEASE, CLINICAL-MANIFESTATIONS, HEMOGLOBIN DISORDERS, DIAGNOSIS, GLOBIN
  • Istanbul University Affiliated: Yes



Objective: Alpha thalassemia syndromes are caused by mutations on one or more of the four α-globin genes. Mutations could

be either more commonly deletional or non-deletional. As some deletions (3.7 and 4.2) cause α+-thalassemia, some cause

(-20.5, MED, THAI, FIL) α0 -thalassemia. The aim of this study was to determine alpha thalassemia mutations in patients with

unsolved hypochromic microcytic anemia and to evaluate types of mutations.

Material and Methods: Two hundred six patients with hypochromic microcytic anemia were evaluated for alpha

thalassemia. A venous blood sample of 2 mL was drawn from each patient for DNA isolation. The samples were investigated

for α-thalassemia mutations by using the Vienna Lab α-Globlin StripAssay TM commercial kit.

Results: Fourteen different mutations were determined in 95 (46.1%) patients. The most common mutation was the 3.7

single gene deletion and was found in 37 patients (n=37/95, 39%). Others common mutations were the 20.5 kb double gene

deletion (n=20 patients, 21%), MED double gene deletion (n=17 patients, 17.9%), α2 IVS1 (n=10 patients, 10.5%), α2 cd142

Hb Koya Dora (n=6 patients, 6.3%), α2 polyA1 (Saudi type) (n=6 patients, 6.3%), 4.2 single gene deletion (n=4 patients, 4.2%),

α1 cd14 (n=2 patients, 2.1%), and -FIL mutation (n=2 patients 2.1%), respectively. Hb Adana, Hb Icaria, α2 init cd and α2

polyA2 (Turkish type) were found in 1% of the patients (n=1). Seven patients (7.4%) had α-thalassemia triplication. In our

study, three mutations (Hb Icaria, α1 cd14, α2 init.cd) were determined firstly in Turkey. Seven mutations (-SEA, -THAI, Hb

Constant Spring, α2 cd19, α2 cd59, α2 cd125, Hb Paksé) were not determined in this study.

Conclusion: Alpha thalassemia should be considered in the differential diagnosis of hypochromic microcytic anemia

especially in cases without iron deficiency and b-thalassemia carrier state. Genetic testing should be performed for the

suspicious cases. We also recommend that a national database with all mutations in Turkey should be created to screen the

alpha thalassemia cost-effectively.