In the pediatric thalassemia ward of Hasan Sadikin General Hospital, children return every few weeks for blood transfusions — a life-saving necessity that carries a hidden cost: iron overload. Excess iron can disrupt vital immune cells, leaving these young patients more vulnerable to infections.

Led by Dr. Mohammad Ghozali, Universitas Padjadjaran researchers analyzed blood from 50 children with transfusion-dependent thalassemia, focusing on monocyte subsets — a type of white blood cell crucial for immune defense. Using flow cytometry, they measured surface markers and correlated the results with iron levels, hemoglobin, and vitamin D status.

Their investigation revealed that higher iron and lower hemoglobin levels were linked to changes in specific monocyte populations, potentially signaling immune dysfunction. Surprisingly, low vitamin D — common in these patients — did not directly correlate with immune cell shifts, suggesting that iron overload may play a more immediate role in altering immune responses.

The study not only uncovers critical pathways in thalassemia-related immune impairment but also points to targeted strategies, such as iron management and immune monitoring, to improve patient outcomes. This aligns with SDG 3 by enhancing care for chronic blood disorders, while strengthening Indonesia’s expertise in pediatric hematology.