Thalassemia Major and Intermedia in Patients Older than 35 Years: A Single Center Experience

Isr Med Assoc J. 2017 Dec;19(12):767-771.

Abstract

Background: During the past decades, beta thalassemia major (TM) and beta thalassemia intermedia (TI) have transformed from a universally fatal disease at a young age into a chronic disease. This advancement is attributed to improved chelation therapy as well as enhanced management strategies, with focused attention on disease and treatment-related complications.

Objectives: To describe characteristics of adults with thalassemia as well as treatment modalities, disease and treatment-related complications, and socioeconomic information of the patients.

Methods: We preformed a retrospective analysis of 14 adult patients > 35 years of age with TM and TI who were treated at our institute, a single center specializing in the care of adult thalassemia patients living in Israel, between the years 2006 and 2016.

Results: The median age of patients was 37 years and most patients were transfusion-dependent. The median number of chelation therapeutic lines was three, and 85.7% of patients were treated at one point by combination chelation therapy. Most patients suffered from at least some form of endocrine dysfunction (n=12), and four patients developed overt heart failure. Of the patients, 85% had completed at least a high school education, 78% were employed, and 64.2% were married.

Conclusions: Prolonged survival of thalassemia patients in recent years has been accompanied by a new set of challenges for both the patients and the treating staff. Further research is warranted to improve both medical management and the socioeconomic well-being of this unique group of adult thalassemia patients.

MeSH terms

  • Adult
  • Blood Transfusion / methods*
  • Chelation Therapy / methods*
  • Combined Modality Therapy / methods*
  • Female
  • Humans
  • Israel / epidemiology
  • Male
  • Needs Assessment
  • Outcome and Process Assessment, Health Care
  • Retrospective Studies
  • Socioeconomic Factors
  • Survival Analysis
  • beta-Thalassemia* / diagnosis
  • beta-Thalassemia* / epidemiology
  • beta-Thalassemia* / physiopathology
  • beta-Thalassemia* / therapy