Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Insights into Hepatocellular Carcinoma in Patients with Thalassemia: From Pathophysiology to Novel Therapies

Version 1 : Received: 27 June 2023 / Approved: 28 June 2023 / Online: 28 June 2023 (03:55:10 CEST)

A peer-reviewed article of this Preprint also exists.

Lin, P.-C.; Hsu, W.-Y.; Lee, P.-Y.; Hsu, S.-H.; Chiou, S.-S. Insights into Hepatocellular Carcinoma in Patients with Thalassemia: From Pathophysiology to Novel Therapies. Int. J. Mol. Sci. 2023, 24, 12654. Lin, P.-C.; Hsu, W.-Y.; Lee, P.-Y.; Hsu, S.-H.; Chiou, S.-S. Insights into Hepatocellular Carcinoma in Patients with Thalassemia: From Pathophysiology to Novel Therapies. Int. J. Mol. Sci. 2023, 24, 12654.

Abstract

Thalassemia is a heterogeneous congenital hemoglobinopathy common in the Mediterranean region, Middle East, Indian subcontinent, and Southeast Asia with increasing incidence in Northern Europe and North America due to immigration. Iron overloading is one of the major long-term complications in patients with thalassemia and can lead to organ damage and carcin-ogenesis. Hepatocellular carcinoma (HCC) is one of the most common malignancies in both transfusion-dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT). The incidence of HCC in patients with thalassemia has increased over time, as better chelation therapy confers a sufficiently long lifespan for the development of HCC. The mechanisms of iron overloading-associated HCC development include the increased reactive oxygen species (ROS), inflammation cytokines, dysregulated hepcidin, and ferroportin metabolism. The treat-ment of HCC in patients with thalassemia was basically similar to those in general population. However, due to the younger age of HCC onset in thalassemia, regular surveillance for HCC development is mandatory in TDT and NTDT. Other supplemental therapy and experience of novel treatment for HCC in thalassemia population were also reviewed in this article.

Keywords

Hepatocellular carcinoma (HCC); Thalassemia; Iron; Transfusion-Dependent Thalassemia (TDT); Non-Transfusion-Dependent Thalassemia (NTDT); Reactive Oxygen Species (ROS)

Subject

Medicine and Pharmacology, Hematology

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