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Mousavi SS, Karami H, Tamadoni A, Mahmoudi H, Shekarriz R, Siami R, Hashemi-Soteh MB. Spectrum of Beta-Thalassemia Mutations in Potential Carriers with Microcytic Hypochromic Anemia from Mazandaran and Golestan, Northern Provinces of Iran. BIOMED RESEARCH INTERNATIONAL 2024; 2024:8664803. [PMID: 38322302 PMCID: PMC10846921 DOI: 10.1155/2024/8664803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/04/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024]
Abstract
Introduction β-Thalassaemia is the most common genetic disorder and is considered as a major public health concern in Iran. Different countrywide studies have shown a heterogeneous mutational basis of β-thalassaemia with different frequencies in each area. This study is aimed at investigating the common and rare mutations in Mazandaran and Golestan, northern provinces of Iran. Methods 5425 microcytic and hypochromic individuals were investigated from Mazandaran and Golestan provinces. From these, 1323 beta carrier or affected individuals were selected where 938 persons were from Mazandaran and 385 people were from Golestan province, respectively. Result 53 different mutations were identified, IVSII-1 (G>A) was the most common (59.14%) followed by Cd 22/23/24 (-7 bp) (5.34%), Cd 8 (-AA) (4.93%), Cd30 (G>A) (4.00%), and IVSI-5 (G>C) (3.70%) with a total of 77.11% in Mazandaran Province, respectively. In Golestan Province, IVSI-5 (G>C) was the most frequent (44.62%) followed by IVSII-1 (G>A) (27.18%), Cd 15 (TGG>TAG) (4.36%), Fr 8/9(+G) (3.85%), and Cd 8(-AA) (2.05%) with a total of 82.06%, respectively. From the 53 different mutations, 22 numbers have been observed in both provinces. Two deletions of the beta gene named Sicilian and Asian-Indian have been detected in Mazandaran with a frequency of 0.72% each. Conclusion The 53 different mutations identified in this study were the most ever reported mutations in the country. Due to diversity of different ethnic groups, there are many varieties of mutation in beta globin gene in Iran. It could be assumed that both founder effect and natural selection caused by migration from neighboring areas have complemented each other to produce the high frequency of unique alleles within each region.
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Affiliation(s)
| | - Hossein Karami
- Department of Pediatrics Hematology & Oncology, Thalassemia Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Tamadoni
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hassan Mahmoudi
- The Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ramin Shekarriz
- Department of Hematology and Oncology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rita Siami
- Ghaemshahr Health Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Mohammad Bagher Hashemi-Soteh
- Immunogenetic Research Center, Molecular and Cell Biology Research Center, Biochemistry and Genetic Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
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El-Shanshory MR, Sherief LM, Yahia S, Ragab SM, Mansour AK, Hassab HM, Hesham MA, Ahmed AS, Beshir MR, El Fotoh WMA, El Naby SAA, Alllah AMG, Khalifa NA, Soliman MA, El-Dahtory F, El-Farahaty RM, Osman E, Elhabyan A, El-Lateef AEA, Kamal NM, Kabbash IA, Saied SM, Eid AR. Beta Thalassemia Carrier Rate: Problem Burden among High School Children. Curr Pediatr Rev 2023; 19:203-209. [PMID: 35748556 DOI: 10.2174/1573396318666220624142349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/09/2022] [Accepted: 05/09/2022] [Indexed: 02/08/2023]
Abstract
UNLABELLED Background & Aim of the Work: β-Thalassemia (βT) is highly prevalent in some countries like Egypt. Accurate data about actual disease prevalence and heavily prevalent geographic locations are essential to help in early detection and in setting up effective preventive programs. We aim for screening βT carriers among Egyptian high school students in the Delta region. SUBJECTS AND METHODS A cross-sectional multicenter study was carried out on 4320 randomly selected students from four governorates of the Nile Delta region, Egypt. All patients were to be tested for their complete blood count. Those with microcytic hypochromic anemia not caused by iron deficiency were tested for βT carrier status using high-performance liquid chromatography. RESULTS The total prevalence of βT carrier rate was 6.13%. The highest prevalence was detected in Al-Sharkia Governorate, reaching 7.89%, followed by 6.90% in Al-Gharbia Governorate. Al- Dakahilia and Al-Menoufia showed lower rates of 4.86% and 3.73%, respectively. CONCLUSION Despite the premarital national screening program for βT in Egypt, the carrier rate is still high. More effort should be done into the proper implementation of national prevention programs.
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Affiliation(s)
| | - Laila M Sherief
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sohier Yahia
- Pediatric Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Seham M Ragab
- Pediatric Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Ahmed K Mansour
- Pediatric Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.,Faculty of Medicine, Delta University for Science and Technology, Tanta, Egypt
| | - Hoda M Hassab
- Pediatric Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mervat A Hesham
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Adel S Ahmed
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed R Beshir
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Sameh A Abd El Naby
- Pediatric Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Ahmed M Gad Alllah
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Naglaa A Khalifa
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A Soliman
- Clinical Pathology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Faeza El-Dahtory
- Consultant of Biochemistry, Genetic Unit, Children Hospital, Mansoura University, Dakahlia, Egypt
| | - Reham M El-Farahaty
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Engy Osman
- Pediatric Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | | | - Amal E Abd El-Lateef
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Naglaa M Kamal
- Pediatric Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibrahim A Kabbash
- Faculty of Medicine, Tanta University, Public Health, and Community Medicine Department, Tanta, Egypt
| | - Shimaa M Saied
- Faculty of Medicine, Tanta University, Public Health, and Community Medicine Department, Tanta, Egypt
| | - Abdel-Rahman Eid
- Pediatric Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
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A Double-blind Randomized Controlled Trial of Curcumin for Improvement in Glycemic Status, Lipid Profile and Systemic Inflammation in β-Thalassemia Major. J Herb Med 2020. [DOI: 10.1016/j.hermed.2019.100324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Blencowe H, Moorthie S, Darlison MW, Gibbons S, Modell B. Methods to estimate access to care and the effect of interventions on the outcomes of congenital disorders. J Community Genet 2018; 9:363-376. [PMID: 29549604 PMCID: PMC6167260 DOI: 10.1007/s12687-018-0359-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 02/15/2018] [Indexed: 12/11/2022] Open
Abstract
In the absence of intervention, early-onset congenital disorders lead to pregnancy loss, early death, or disability. Currently, lack of epidemiological data from many settings limits the understanding of the burden of these conditions, thus impeding health planning, policy-making, and commensurate resource allocation. The Modell Global Database of Congenital Disorders (MGDb) seeks to meet this need by combining general biological principles with observational and demographic data, to generate estimates of the burden of congenital disorders. A range of interventions along the life course can modify adverse outcomes associated with congenital disorders. Hence, access to and quality of services available for the prevention and care of congenital disorders affects both their birth prevalence and the outcomes for affected individuals. Information on this is therefore important to enable burden estimates for settings with limited observational data, but is lacking from many settings. This paper, the third in this special issue on methods used in the MGDb for estimating the global burden of congenital disorders, describes key interventions that impact on outcomes of congenital disorders and methods used to estimate their coverage where empirical data are not available.
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Affiliation(s)
- Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive, and Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Matthew W Darlison
- Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK.
| | - Stephen Gibbons
- Department of Geography and Environment, London School of Economics, London, UK
| | - Bernadette Modell
- Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK
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Keikhaei B, Slehi-fard P, Shariati G, Khosravi A. Genetics of Iranian Alpha-Thalassemia Patients: A Comprehensive Original Study. Biochem Genet 2018; 56:506-521. [DOI: 10.1007/s10528-018-9857-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 04/03/2018] [Indexed: 11/30/2022]
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Hosoya S. Changes in Attitudes towards Marriage and Reproduction among People with a Genetic Illness. ANTHROPOLOGY OF THE MIDDLE EAST 2017. [DOI: 10.3167/ame.2016.120203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
In this article, the change in attitude towards marriage and reproduction among Iranian people with a genetic illness called thalassemia has been investigated, along with an analysis of the impact brought by the national thalassemia prevention programmes, which were introduced to discourage marriage between carriers (thalassemia minor) and the birth of severe homozygous cases (thalassemia major). Marriage and reproductive choices of people with both thalassemia minor and thalassemia major were focused upon in order to prevent the birth of affected babies. Thalassemia carrier couples prefer to choose abortion of affected foetuses, rather than giving up their marriage, and some people with thalassemia major choose a person with thalassemia major as a marriage partner, though they must give up having their own child.
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Hosoya S. Changes in Attitudes towards Marriage and Reproduction among People with a Genetic Illness. ANTHROPOLOGY OF THE MIDDLE EAST 2017. [DOI: 10.3167/ame.2017.120203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Moudi Z, Miri-Moghaddam E. Decisions Regarding Pregnancy Termination Due to β-Thalassemia Major: a Mixed-Methods Study in Sistan and Baluchestan, Iran. J Genet Couns 2016; 26:556-566. [DOI: 10.1007/s10897-016-0019-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
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Waheed F, Fisher C, Awofeso A, Stanley D. Carrier screening for beta-thalassemia in the Maldives: perceptions of parents of affected children who did not take part in screening and its consequences. J Community Genet 2016; 7:243-53. [PMID: 27393346 DOI: 10.1007/s12687-016-0273-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/22/2016] [Indexed: 11/25/2022] Open
Abstract
The Republic of Maldives (Maldives) is an island nation in the Indian Ocean with a population of 344, 023. Studies show that Maldives has one of the world's highest thalassemia carrier rates. It is estimated that 16-18 % of the Maldivians are β-thalassemia carriers, and approximately 28 new β-thal cases are recorded annually. Poor uptake of screening for the condition is one of the main reasons for this high number of new cases. The aim of this study was to explore the reasons for not testing for thalassemia in Maldives before or after marriage. Findings show that participants did not undergo carrier tests because of poor awareness and not fully knowing the devastating consequences of the condition. The outcomes of not testing were distressing for most participants. Religion played a vital role in all the decisions made by the participants before and after the birth of a β-thal child.
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Affiliation(s)
- Fazeela Waheed
- School of Population Health, University of Western Australia, Perth, Australia.
| | - Colleen Fisher
- School of Population Health, University of Western Australia, Perth, Australia
| | - AwoNiyi Awofeso
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - David Stanley
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, Australia
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Moafi A, Vallian R, Vallian S, Rahgozar S, Torfenajad M, Moafi H. The pros and cons of the fourth revision of thalassaemia screening programme in Iran. J Med Screen 2016; 24:1-5. [DOI: 10.1177/0969141316631007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the repercussions of recent changes to the cut-offs used in the first screening step of the pre-marital screening programme for thalassaemia prevention in Iran. Methods The profiles of 984 subjects referred to a genetic laboratory, and the tests of 242 parents of children with thalassaemia major were assessed for red blood cell (RBC) indices, haemoglobin (Hb) A2 levels and results of Hb electrophoresis. Results Of 407 suspected thalassaemia minor (STM) cases, 18 proved positive for thalassaemia minor on molecular analysis (18/407, confidence interval 2.6–6.9%). If the revised screening cut-offs had been used to determine who would undergo molecular analysis, two of these cases would not have been identified. Only 4.4% of suspected cases with lower than normal RBC indices (mean corpuscular volume <80 fl and mean corpuscular Hb <27 pg) and HbA2 (<3.5%) were diagnosed with thalassaemia minor. Conclusion The thalassaemia major prevention programme is performed in two separate steps. One step involves the screening of subjects and identification of β-thalassaemia minor, suspected cases for thalassaemia minor (STM), and normal subject groups. The other step concerns the identification of thalassaemia minor in the STM group. Changing the cut-offs at the first screening step does not result in significant improvement from an economic view, and is associated with significant risk at the second screening step.
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Affiliation(s)
- Alireza Moafi
- Department of Pediatric Hematology-Oncology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reihaneh Vallian
- Sayed Al-shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadeq Vallian
- Divisions of Genetics, Department of Biology, University of Isfahan, Isfahan, Iran
| | - Soheila Rahgozar
- Divisions of Cellular and Molecular Biology, Department of Biology, University of Isfahan, Isfahan, Iran
| | - Mohammad Torfenajad
- Sayed Al-shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hadi Moafi
- Department of Biology, Faculty of Science, University of British Columbia, Vancouver, Canada
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Saffi M, Howard N. Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review. Public Health Genomics 2015; 18:193-203. [DOI: 10.1159/000430837] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/21/2015] [Indexed: 11/19/2022] Open
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Guidelines for the Standard Monitoring of Patients With Thalassemia: Report of the Thalassemia Longitudinal Cohort. J Pediatr Hematol Oncol 2015; 37. [PMID: 26201037 PMCID: PMC4511957 DOI: 10.1097/mph.0000000000000307] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Chronic transfusion therapy has played a central role in extending life expectancy for patients with hemoglobinopathies such as thalassemia. However, this life-saving therapy is associated with numerous complications that now comprise the bulk of management considerations for patients with thalassemia. This review reports on the experience of the Thalassemia Longitudinal Cohort and reviews available literature to establish guidelines for the management of patients with thalassemia.
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Bamimore MA, Zaid A, Banerjee Y, Al-Sarraf A, Abifadel M, Seidah NG, Al-Waili K, Al-Rasadi K, Awan Z. Familial hypercholesterolemia mutations in the Middle Eastern and North African region: A need for a national registry. J Clin Lipidol 2015; 9:187-94. [DOI: 10.1016/j.jacl.2014.11.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/15/2014] [Accepted: 11/23/2014] [Indexed: 01/01/2023]
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Hashemieh M, Timori Naghadeh H, Tabrizi Namini M, Neamatzadeh H, Hadipour Dehshal M. The Iran Thalassemia Prevention Program: Success or Failure? IRANIAN JOURNAL OF PEDIATRIC HEMATOLOGY AND ONCOLOGY 2015; 5:161-6. [PMID: 26705456 PMCID: PMC4688601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 07/24/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Iran is one of the countries located on the "thalassemia belt" and a thalassemia prevention program was approved in our country in 1995. Many different researchers have studied the success of this program with no unanimous findings. MATERIAL AND METHODS A comprehensive literature search was performed using PubMed, Web of Science, and Google Scholar databases in Farsi and English languages for relevant articles published up to March 2015. RESULTS A total of 46 articles regarding thalassemia prevention were identified. After screening the titles and abstracts, 27 articles were excluded because they were the same articles, review articles, and case reports. Finally, 16 articles about the success of the Iranian thalassemia prevention program were selected for the evaluation. CONCLUSION The findings show that the program has been significantly successful in the reduction of the new thalassemia births, though not in a few provinces like Sistan and Baluchestan. The role of the network of genetic labs has been also indispensable in the reduction of the new births. However, there is ambiguity over the impact of the program on the attitude and awareness of people across the country about the prevention of inherited diseases. However, with the success of the Iran thalassemia prevention program, it needs to be modified to be more compatible with the relevant social textures of different provinces.
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Affiliation(s)
- M Hashemieh
- Associated professor, Pediatric hematologist and oncologist, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - H Timori Naghadeh
- Research Center of Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - M Tabrizi Namini
- Research Center of Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - H Neamatzadeh
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
| | - M Hadipour Dehshal
- Research Center of Iranian Blood Transfusion Organization, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.,Corresponding Author Hadipour Dehshal M Pharm.D, Iranian Blood Transfusion Organization (IBTO) Research Centre, 9th Floor, IBTO Main Building, Hemat Expressway, Tehran, Iran, E-mail:
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Abstract
Thalassemia is the most common monogenic inherited disease worldwide and it affects most countries to various extents. This review summarizes the current approaches to phenotypic and genotypic diagnosis of thalassemia in clinical practice. Prevention strategies that encompass carrier screening, genetic counseling and prenatal diagnosis are discussed. The importance of public education and an awareness of a changing perception regarding this group of diseases are emphasized. It also addresses the impact of the rapidly increasing knowledge in disease severity modification by hemoglobin F (Hb F).
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Affiliation(s)
- Ho-Wan Ip
- Department of Pathology and Clinical Biochemistry, Queen Mary Hospital , Hong Kong SAR , China and
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