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Thalassemia

Thalassemia is a genetic blood disorder in which the body makes an abnormal form of hemoglobin (the protein molecule in red blood cells) causing red blood cells to be easily destroyed or broken. Thalassemia is passed down through families and can be found in both male and female.

There are 2 groups of thalassemia according to the severity:
  1. Thalassemia major: symptoms vary depending on severity and types of thalassemia they have, from mild to serious ones.
  2. Thalassemia minor or carrier: most patients of this group are just as healthy as normal people. They just carry thalassemia traits which can be passed down to their children.
  1. See hematologist to learn more about the disease.
  2. When planning to marry or have children, please bring your spouse to health check in order to find out the chance that children might have it.
The treatment depends on the severity of the disease.
  1. Maintain good health.
  • Avoid eating iron rich food such as blood, liver, spinach, etc.  
  • Discontinue iron supplementary medicines or vitamins.
  • Lower iron absorption by eating turmeric or drinking tea, etc.
  • See a dentist every six months to detect decay.
  • Avoid working too hard or strenuous activities.
  • Avoid alcohol and drugs.
  • Do not take over-the-counter vitamin C without prescription.
  • Avoid infection by spending time in well-ventilated areas.
  • If you experience severe pain under your right ribs, have a fever, and have jaundice, please keep in mind that you might have cholecystitis. See a doctor immediately.
  1. Transfusion
  • A transfusion is not necessary for mild anemia.
  • For thalassemia patients with moderate severity, if you are obviously pale or fatigue, blood transfusion should make you feel better but consideration will be made on a case by case basis.
  • Patients with severe thalassemia usually show symptoms in early childhood and are very anemic. The doctor may recommend regular transfusions until the anemia is completely treated to prevent complications, such as deformities of the bones and enlarged spleen. Transfusion also has risks, including infections and excessive iron, which requires an iron chelating agent at the same time.
  1. Iron chelating agents
Too much iron accumulation in various organs could be harmful to the body. It needs to be eliminated by either injection or oral medicine. The doctor will inject deferoxamine or Desferal® either under the skin or intravenously. When this medication will be used and in what dosage will be determined by the amount of excess iron and the blood transfused.
  1. Spleen removal
  • This is done only in a patient whose spleen is enlarged, who is suffering from severe anemia, and who needs blood transfusions more closely together. This procedure is not recommended for children younger than four to five years old as the removal of the spleen can increase the risk of infection.
  • In the patient who must undergo removal of the spleen, the pneumococcal and Haemophilus vaccine is recommended before a scheduled splenectomy.
  1. Bone marrow transplant
This is the only treatment option that completely cures thalassemia. It is usually very effective in young patients. Currently, cord blood can be used as a source of stem cell, but this treatment is very expensive.

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