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Thalassemia Major: A Serious Disorder

The more severe form of the disease is thalassemia major, also called Cooley's Anemia. It is a serious disease that requires regular blood transfusions and extensive medical care.
Those with thalassemia major usually show symptoms within the first two years of life. They become pale and listless and have poor appetites. They grow slowly and often develop jaundice. Without treatment, the spleen, liver and heart soon become greatly enlarged. Bones become thin and brittle. Heart failure and infection are the leading causes of death among children with untreated thalassemia major.
The use of frequent blood transfusions and antibiotics has improved the outlook for children with thalassemia major. Frequent transfusions keep their hemoglobin levels near normal and prevent many of the complications of the disease. But repeated blood transfusions lead to iron overload - a buildup of iron in the body - that can damage the heart, liver and other organs. Drugs known as "iron chelators" can help rid the body of excess iron, preventing or delaying problems related to iron overload.
Thalassemia has been cured using bone marrow transplants. However, this treatment is possible only for a small minority of patients who have a suitable bone marrow donor. The transplant procedure itself is still risky and can result in death.

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Thalassemia Minor: Understanding the Silent Carrier

Introduction: Thalassemia is a genetic blood disorder characterized by abnormal hemoglobin production, leading to anemia. Thalassemia minor, also known as thalassemia trait or carrier state, is the mildest form of thalassemia. Individuals with thalassemia minor typically have one normal hemoglobin gene and one mutated hemoglobin gene. Although it is considered a mild condition, understanding thalassemia minor is crucial due to its implications for genetic counseling and potential complications during pregnancy. Genetic Basis and Inheritance: Thalassemia minor is inherited in an autosomal recessive manner, meaning that both parents must carry the gene mutation for their child to have thalassemia minor. The mutated genes affect the production of either the alpha or beta globin chains that make up hemoglobin, the protein responsible for carrying oxygen in the blood. The severity of thalassemia is influenced by the specific gene mutation and the extent to which the normal gene is affected....

Diagnosis

Thalassemia can be diagnosed in different ways. Some types can be found on routine blood tests that show that the red blood cells are small or the patient is anemic. Testing of parents can be done before pregnancy to determine whether there is a risk of having a child with a severe form of thalassemia. The illness can be seen in sophisticated genetic testing, and can be found prenatally through amniocentesis or chorionic villus sampling (CVS).

Innovations and Research

As one of five thalassemia centers in the United States designated by the National Institutes of Health, the Children's Hospital Boston thalassemia program provides patients with access to experts in the field and the most cutting-edge clinical trials available in the world. One promising recent study, now awaiting approval by the FDA, tested the effectiveness of a new oral iron chelator, deferisirox. Researchers from Children's Hospital Boston have been at the forefront of thalassemia research and treatment for decades. Important advances in the field that were made here include: • Recognition of the important role of hypertransfusion by Dr. David Nathan, Senior Associate in Hematology, in the 1960s. • Demonstration of effective iron chelation by subcutaneous pump deferoxamine (Desferal ®) by Dr. Richard Proper and David Nathan in the 1970s. • Elucidation of the molecular biology of thalassemia syndromes by Drs. Nathan, YW Kan, Stuart Orkin and others.