Effects of optimized transfusion therapy on hematologic and biochemical profiles of patients. (A) The trend in the pretransfusion reticulocyte count (%) in 4 patients with homozygous α⁰-thalassemia on standard transfusion therapy before commencement of new transfusion regimen. The dashed line represents LOESS fit line with 95% confidence bands. (B) The trend in the pretransfusion Hb H level in peripheral blood. The dotted line represents the 15% target. (C-F) The trends in pretransfusion unconjugated bilirubin, STR, LDH, and reticulocyte count. Shaded areas indicate laboratory results before the implementation of new transfusion regimen (day 0). The dotted lines represent upper boundaries of normal values. We used repeated-measure analysis of variance to examine the association between intervention and biochemical or hematologic outcomes. Overall, intervention effect was significant for all laboratory outcomes. Moreover, the effects of intervention on improvement of outcomes remained persistent for each of the postintervention time brackets (0-120, 121-240, and 241-365 days). Eight to 12 months after the intervention, the average lactate dehydrogenase (964.37 [standard deviation [SD]: 239.85] vs 2736.75 [SD: 242.44]), indirect bilirubin (22.03 [SD: 5.53] vs 57.38 [SD: 10.45]), soluble transferrin receptor (2.15 [SD: 0.58] vs 7.31 [SD: 0.91]), and reticulocyte count (354.22 [SD: 36.42] vs 631.87 [SD: 82.54]) were all significantly lower compared with preintervention. (G-H) Associations of “functional” hemoglobin with STR and Hb H level with LDH. Dotted lines represent target values for functional hemoglobin and Hb H%, as well as the upper boundaries of normal values for LDH and STR. (See supplemental Materials available on the Blood Web site for the details of statistical analysis).