Prevention and control of thalassemia in Guangdong Province, Southern China: insights from an 11-year retrospective study

中国南方广东省地中海贫血症的预防和控制:一项为期11年的回顾性研究的启示

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Abstract

BACKGROUND: Thalassemia, a prevalent monogenic inherited disorder, represents a significant public health concern in southern China. This comprehensive study retrospectively analysed prenatal diagnostic data for thalassemia over an 11-year period in Guangdong Province, a high-prevalence region in southern China. METHODS: Prenatal diagnosis (PND) of thalassemia was performed on 22,127 foetuses from at-risk pregnancies, following standardized protocols for invasive sampling, foetal sample collection and laboratory processing. Thalassemia mutations were identified using PCR-based molecular techniques. RESULTS: The analysis revealed that 16,812 cases (75.98%) were diagnosed with thalassemia, including 12,636 cases (57.11%) identified as α-thalassemia, 3961 cases (17.90%) as β-thalassemia and 215 cases (0.97%) as co-inheritance of α- and β-thalassemia. Among these, 5769 cases (26.08%) were diagnosed with intermedia or severe thalassemia genotypes, of which 2593 underwent pregnancy termination. Additionally, our study detected 275 cases of rare thalassemia variants. The retrospective analysis encompassed critical aspects including the timing of PND, genotype spectrum and rare variant identification, complemented by a synthesis of clinical practice insights. CONCLUSIONS: This large-scale study provides substantial epidemiological data and clinical insights that significantly contribute to the enhancement of thalassemia prevention and control strategies in Guangdong Province.

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