Introduction & Objective: Thalassemia is the most common genetic disorders in the world. These disorders are common in the Middle Estern countries containing Iran. It seems that factors like splenectomy, iron overload, frequent contacts with antigens during blood transfusion & using chelating agents cause severe disturbances to immune system. This study is done to evaluate the immune status in thalasemic patients refered to Ahvaz Shafa Hospital.

Materials & Methods: This case- control study was done on 40 major thalassemic patients who had not the history of frequent bacterial and viral infections, splenectomy, using immunosuppressive drugs & patients with hepatitis, diabetes or other chronic diseases. Control group contained 31 healthy persons. Peripheral blood samples were collected from all participants. The last CBC and serum ferritin was taken from patient files. NBT test, evaluation of CD4, CD8, CD5 , CD20 markers with flowcytometry, and assessment of IgG, IgM, and IgA levels with nephlometry method carried out on peripheral blood samples of patient and control groups.

Results: The percent of CD4, CD8 and CD5 markers and CD4/CD8 ratio had no significant difference between case & control groups. The percent of CD20 marker, and IgG , IgM & IgA levels were significantly higher in case group in comparison with control group. NBT test in all case and control groups were normal. There was no significant difference in serum ferritin, WBC count and percentage of lymphocytes and neutrophils among two groups.

Conclusion: In major thalassemia patients, cellular immunity and phagocytosis are similar to normal individuals. CD4, CD8 and CD5 positive lymphocytes and CD4/CD8 ratio showed no difference between patients and normal groups. CD20 positive lymphocytes and IgM, IgG & IgA levels in patient group were significantly higher than normal control group. This can’t be due to viral or recurrent infections, because these patients were excluded from our study. This may related to increase in allo antibodies & auto antibodies due to frequent blood transfusion and antigen contact with in these patients which is not related to additional iron.