Impact of Splenectomy on Natural Killer and T Lymphocyte Levels in Pediatric Transfusion-Dependent β-Thalassemia Major

Elbassal, Fathia I.; Soliman, Mohamed A.; Sharaf, Nourhan H.; Abd El-Hamid, Mai E.; El-sheity, Hanan H.

doi:10.21608/ejmm.2025.404815.1782

	Impact of Splenectomy on Natural Killer and T Lymphocyte Levels in Pediatric Transfusion-Dependent β-Thalassemia Major
Egyptian Journal of Medical Microbiology
Article 64, Volume 35, Issue 1, January 2026
Document Type: New and original researches in the field of Microbiology.
DOI: 10.21608/ejmm.2025.404815.1782
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Authors
Fathia I. Elbassal¹; Mohamed A. Soliman¹; Nourhan H. Sharaf ¹; Mai E. Abd El-Hamid²; Hanan H. El-sheity¹
¹Clinical Pathology Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt
²Pediatrics Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt
Abstract
*Background: In transfusion-dependent β-thalassemia major (β-TM), repeated transfusions lead to iron overload and immune system compromise. Splenectomy further weaken immunity, increasing infection risk. Objectives: To investigate the impact of splenectomy on T lymphocyte and natural killer (NK) levels in pediatric patients with transfusion-dependent (β-TM). Methodology: Fifty-one β-TM patients were studied (35 non-splenectomized and16 splenectomized). Blood count, Serum ferritin, CD3⁺ T lymphocyte, and CD3⁻/CD16⁺CD56⁺ NK cell were measured. Results:* Splenectomized patients had significantly higher hemoglobin, White blood cell, neutrophils, and lymphocytes counts (P = 0.0007, 0.047, 0.0001, and 0.031, respectively). However, they showed significantly lower NK and T cell levels (P = 0.031 and 0.011). No significant differences were seen in ferritin levels, transfusion frequency, or chelation therapy. The splenectomized group had a higher average age and more cardiovascular complications. A negative correlation between ferritin and NK cells in the non-splenectomized group (P = 0.014), while in the splenectomized group, ferritin negatively correlated with CD3⁺ T cells (P = 0.036). Conclusion: Splenectomy improve anemia in β-TM patients but does not lower iron over load or transfusion needs. It is associated with reduced NK and T lymphocyte levels, indicating impaired immune function.
Keywords
transfusion dependent β-TM; natural killer cell; Splenectomy


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