Thalassemia major is a hereditary hemoglobinopathy characterized by ineffective erythropoiesis and severe anemia, necessitating lifelong blood transfusions(1,2). Regular transfusions lead to iron overload, a primary driver of growth retardation in affected children. Iron accumulation in tissues like the pituitary and liver disrupts growth hormone secretion and insulin-like growth factor-1 production.

Inclusion Criteria:

• Children aged 1 to 18 years diagnosed with β-thalassemia major based on hemoglobin electrophoresis or high-performance liquid chromatography (HPLC).
• Receiving regular blood transfusions as part of standard management at AUCH.
• Attending the hematology unit for at least one year prior to enrollment.

Exclusion Criteria:

• • Children with other types of thalassemia.

  • Presence of congenital diseases, chronic illnesses other than thalassemia (e.g., malignancy, tuberculosis, chronic hepatitis, congenital heart disease, chronic renal failure, epilepsy, diabetes mellitus), or primary endocrinopathies.
  • Patients with other causes of short stature, such as hereditary bone dysplasia or systemic disorders.

All children with transfusion-dependent beta-thalassemia major attending the AUCH Hematology Unit will be screened for eligibility.