Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review

Introduction Thalassemia is an endemic genetic disease. The main clinical manifestation of this condition is long-term chronic anemia. In addition, patients may present with jaundice, heart failure, hepatosplenomegaly, skeletal deformities, growth retardation, and cognitive impairment. Hematopoietic...

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Main Authors: Zhihao Wu, Yinan Zhang, Jiaxu Fang, Xiaohong Yang, Ying Guan, Yuefu Zhan, Jianqiang Chen
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2543107
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author Zhihao Wu
Yinan Zhang
Jiaxu Fang
Xiaohong Yang
Ying Guan
Yuefu Zhan
Jianqiang Chen
author_facet Zhihao Wu
Yinan Zhang
Jiaxu Fang
Xiaohong Yang
Ying Guan
Yuefu Zhan
Jianqiang Chen
author_sort Zhihao Wu
collection DOAJ
description Introduction Thalassemia is an endemic genetic disease. The main clinical manifestation of this condition is long-term chronic anemia. In addition, patients may present with jaundice, heart failure, hepatosplenomegaly, skeletal deformities, growth retardation, and cognitive impairment. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment.Areas covered Cognitive impairment in patients with thalassemia has received increasing attention, and related studies have confirmed that patients with thalassemia have varying degrees of cognitive dysfunction. Potential contributing factors include white matter damage, ischemia, hypoxia, and systemic iron overload. However, the specific underlying mechanisms remain unclear and require further investigation. This study aimed to systematically integrate the currently fragmented mechanisms of cognitive impairment in patients with thalassemia.Methods PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were used to search for related literature. The main contents of this review include the latest progress in the diagnosis and treatment of thalassemia and the mechanism of cognitive impairment in patients.Conclusion Cognitive impairment in patients with thalassemia includes deficits in spatial memory, computing power, executive operation, emotional communication, and other domains. Several contributing factors have been identified, including white matter damage, ischemia, hypoxia, iron deposition in the brain, and accelerated aging. Iron overload has recently emerged as a research hotspot. However, the exact location, extent, and mechanism of cerebral iron deposition remain unclear. Despite many challenges in the current research, greater breakthroughs are expected in the diagnosis and treatment of cognitive dysfunction in thalassemia, ultimately improving patients’ quality of life.
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spelling doaj-art-ba953dcd2ee54a4fac73bd6a0f4014ec2025-08-20T03:36:45ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2543107Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive reviewZhihao Wu0Yinan Zhang1Jiaxu Fang2Xiaohong Yang3Ying Guan4Yuefu Zhan5Jianqiang Chen6Department of Radiology, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaDepartment of Radiology, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaDepartment of Radiology, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaDepartment of Radiology, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaDepartment of Ultrasound, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaDepartment of Radiology, the Third People's Hospital of Longgang, Clinical Institute of Shantou University Medical College (The Third People's Hospital of Longgang District Shenzhen), Shenzhen, ChinaDepartment of Radiology, the First Clinical College, the First Affiliated Hospital, Hainan Medical University, Haikou, ChinaIntroduction Thalassemia is an endemic genetic disease. The main clinical manifestation of this condition is long-term chronic anemia. In addition, patients may present with jaundice, heart failure, hepatosplenomegaly, skeletal deformities, growth retardation, and cognitive impairment. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment.Areas covered Cognitive impairment in patients with thalassemia has received increasing attention, and related studies have confirmed that patients with thalassemia have varying degrees of cognitive dysfunction. Potential contributing factors include white matter damage, ischemia, hypoxia, and systemic iron overload. However, the specific underlying mechanisms remain unclear and require further investigation. This study aimed to systematically integrate the currently fragmented mechanisms of cognitive impairment in patients with thalassemia.Methods PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were used to search for related literature. The main contents of this review include the latest progress in the diagnosis and treatment of thalassemia and the mechanism of cognitive impairment in patients.Conclusion Cognitive impairment in patients with thalassemia includes deficits in spatial memory, computing power, executive operation, emotional communication, and other domains. Several contributing factors have been identified, including white matter damage, ischemia, hypoxia, iron deposition in the brain, and accelerated aging. Iron overload has recently emerged as a research hotspot. However, the exact location, extent, and mechanism of cerebral iron deposition remain unclear. Despite many challenges in the current research, greater breakthroughs are expected in the diagnosis and treatment of cognitive dysfunction in thalassemia, ultimately improving patients’ quality of life.https://www.tandfonline.com/doi/10.1080/16078454.2025.2543107Thalassemiacognitive impairmentiron depositioninfluencing factors
spellingShingle Zhihao Wu
Yinan Zhang
Jiaxu Fang
Xiaohong Yang
Ying Guan
Yuefu Zhan
Jianqiang Chen
Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
Hematology
Thalassemia
cognitive impairment
iron deposition
influencing factors
title Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
title_full Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
title_fullStr Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
title_full_unstemmed Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
title_short Influencing factors of cognitive impairment in patients with thalassemia: a comprehensive review
title_sort influencing factors of cognitive impairment in patients with thalassemia a comprehensive review
topic Thalassemia
cognitive impairment
iron deposition
influencing factors
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2543107
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