en Adults Hematology & Oncology Adults Hematology & Oncology <p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Arial;"><strong>Background: </strong>This meta-analysis was conducted to summarize the comparative effect of Vitamin E and N-acetyl cysteine (NAC) on oxidative status, including total antioxidant capacity (TAC), total oxidative stress (TOS), oxidative stress index (OSI), and hemoglobin (Hb) in patients with TDT.<br> <strong>Methods:</strong> This systematic review and meta-analysis was done according to the PRISMA checklist. We searched databases including Web of Science (ISI), Scopus, Medline (via PubMed), and Embase. Meta-analysis was done using Stata statistical software version 16.0.<br> <strong>Results:</strong> Finally, four randomized-controlled trials (RCT) for Vitamin E and three RCTs for NAC were included. Our meta-analyses and review showed a significant increase in the weighted mean differences (WMD) of Hb and a significant decrease in the WMD of TOS and OSI in children subgroup of Vitamin E. Also, based on the results of the review in the NAC group, a significant increase in the WMD of Hb and a significant decrease in the WMD of TOS and OSI were found in children.<br> <strong>Conclusions: </strong>Vitamin E showed a beneficial effect on improving anemia in TDT children. Moreover, both NAC and Vitamin E seems to be effective antioxidant supplements in children with TDT. More well-designed randomized, controlled trials for the effect of NAC and Vitamin E in TDT patients are recommended with more focus on the essential influencing factors on the oxidative status in these patients.<br> <br> <a href="./files/site1/files/Suppelementary_1.docx">./files/site1/files/Suppelementary_1.docx</a><br> .<br> <a href="./files/site1/files/Suppelementary_2.docx">./files/site1/files/Suppelementary_2.docx</a></span></span><br> <br> &nbsp;</p> Acetyl cysteine, Meta-Analysis, Transfusion-dependent thalassemia, Vitamin E 22 35 http://ijbc.ir/browse.php?a_code=A-10-913-1&slc_lang=en&sid=1 Sezaneh Haghpanah haghpanah@sums.ac.ir 10031947532846009384 10031947532846009384 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mahnaz Hosseini-Bensenjan m.hosseyni42@gmail.com 10031947532846009385 10031947532846009385 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Omid reza Zekavat ozekavat@gmail.com 10031947532846009386 10031947532846009386 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mohammadreza Bordbar mbordbar53@gmail.com 10031947532846009387 10031947532846009387 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mehran Karimi mkarimi820@gmail.com 10031947532846009388 10031947532846009388 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Mani Ramzi ramzim43@yahoo.com 10031947532846009389 10031947532846009389 No Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Naeimehossadat Asmarian shirinparand47@gmail.com 10031947532846009390 10031947532846009390 Yes Anesthesiology and Critical Care Research Center, Shiraz University of Medical Science, Shiraz, Iran