What is the definition of Thalassemia?

Thalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form or inadequate amount of hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen. The disorder results in large numbers of red blood cells being destroyed, which leads to anemia.

What are the alternative names for Thalassemia?

Mediterranean anemia; Cooley anemia; Beta thalassemia; Alpha thalassemia

What are the causes for Thalassemia?

Hemoglobin is made of two proteins:

  • Alpha globin
  • Beta globin

Thalassemia occurs when there is a defect in a gene that helps control production of one of these proteins.

There are two main types of thalassemia:

  • Alpha thalassemia occurs when a gene or genes related to the alpha globin protein are missing or changed (mutated).
  • Beta thalassemia occurs when similar gene defects affect production of the beta globin protein.

Alpha thalassemias occur most often in people from Southeast Asia, the Middle East, China, and in those of African descent.

Beta thalassemias occur most often in people of Mediterranean origin. To a lesser extent, Chinese, other Asians, and African Americans can be affected.

There are many forms of thalassemia. Each type has many different subtypes. Both alpha and beta thalassemia include the following two forms:

  • Thalassemia major
  • Thalassemia minor

You must inherit the gene defect from both parents to develop thalassemia major.

Thalassemia minor occurs if you receive the faulty gene from only one parent. People with this form of the disorder are carriers of the disease. Most of the time, they do not have symptoms.

Beta thalassemia major is also called Cooley anemia.

Risk factors for thalassemia include:

  • Asian, Chinese, Mediterranean, or African American ethnicity
  • Family history of the disorder

What are the symptoms for Thalassemia?

The most severe form of alpha thalassemia major causes stillbirth (death of the unborn baby during birth or the late stages of pregnancy).

Children born with beta thalassemia major (Cooley anemia) are normal at birth, but develop severe anemia during the first year of life.

Other symptoms can include:

  • Bone deformities in the face
  • Fatigue
  • Growth failure
  • Shortness of breath
  • Yellow skin (jaundice)

People with the minor form of alpha and beta thalassemia have small red blood cells but no symptoms.

What are the current treatments for Thalassemia?

Treatment for thalassemia major often involves regular blood transfusions and folate supplements.

If you receive blood transfusions, you should not take iron supplements. Doing so can cause a high amount of iron to build up in the body, which can be harmful.

People who receive a lot of blood transfusions need a treatment called chelation therapy. This is done to remove excess iron from the body.

A bone marrow transplant may help treat the disease in some people, especially children.

What is the outlook (prognosis) for Thalassemia?

Severe thalassemia can cause early death (between ages 20 and 30) due to heart failure. Getting regular blood transfusions and therapy to remove iron from the body helps improve the outcome.

Less severe forms of thalassemia often do not shorten lifespan.

You may want to seek genetic counseling if you have a family history of the condition and are thinking of having children.

What are the possible complications for Thalassemia?

Untreated, thalassemia major leads to heart failure and liver problems. It also makes a person more likely to develop infections.

Blood transfusions can help control some symptoms, but carry a risk of side effects from too much iron.

When should I contact a medical professional for Thalassemia?

Call your provider if:

  • You or your child has symptoms of thalassemia.
  • You are being treated for the disorder and new symptoms develop.
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REFERENCES

Cappellini MD. The thalassemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 153.

Chapin J, Giardina PJ. Thalassemia syndromes. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 40.

Smith-Whitley K, Kwiatkowski JL. Hemoglobinopathies. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 489.

  • Condition: Non-Immune Hydrops Fetalis Secondary to Congenital Chylothorax with Diffuse Interstitial Lung Disease
  • Journal: BMJ case reports
  • Treatment Used: Pleural Drainage, High-Frequency Oscillation, Inhaled Nitric Oxide Therapy, Non-Invasive Ventilation, and Dexamethasone
  • Number of Patients: 1
  • Published —
This case report describes a Chinese male infant diagnosed with non-immune hydrops fetalis secondary to congenital chylothorax (fluid in pleural space) with diffuse interstitial lung disease treated with pleural drainage, high-frequency oscillation, inhaled nitric oxide therapy, non-invasive ventilation, and dexamethasone.
  • Condition: Iranian Patients with Thalassemia
  • Journal: BMC psychology
  • Treatment Used: Positive Thinking Program
  • Number of Patients: 78
  • Published —
This study determined the effects of a positive thinking training program on hope and sleep quality of patients with thalassemia major (blood disorder).