Review Article
Volume 16 Issue 7 - 2020
Review on Thalassemia Epidemiology and Management in Children
Raniyah Embarak D Alharbi1*, Abdulaziz Hameed H Alluhaibi2, Zaki Ghali Alhothli2, Sara Faisal Alhassan2, Bayan Mohammed Almehmadi2, Shatha Abdulaziz Al Zaydi2, Raghdah Khamees Al Harbi3, Hamad Rasheed Alotaibi4 and Afnan Mohammed Al Gethami5
1Pediatric Intensivist in Hera General Hospital, Residents Training Programs Director, Head of Pediatric Critical Care Scientific Council, Mecca, Saudi Arabia
2Hera General Hospital, Mecca, Saudi Arabia
3King Abdulaziz Hospital, Saudi Arabia
4Shaqra University, Saudi Arabia
5Pediatric Resident, Taif Children Hospital, Taif, Saudi Arabia
*Corresponding Author: Raniyah Embarak D Alharbi, Pediatric Intensivist in Hera General Hospital, Residents Training Programs Director, Head of Pediatric Critical Care Scientific Council, Mecca, Saudi Arabia.
Received: June 08, 2020; Published: June 23, 2020


Background: Thalassemia is a genetic disorder which involves the formation of abnormal hemoglobin. Thalassemia is autosomal recessive, meaning both parents must be affected with the disease or carriers for it to be passed to the next generation.

A patient with thalassemia not only has low levels of hemoglobin present in his or her bloodstream but also lacks good quality hemoglobin. Although some mild forms of thalassemia can even go unnoticed and cause only mild anemia and patients with iron deficiency problems, some more serious types of thalassemia can also lead to death.

Aim of the Study: This review aims to highlight epidemiology and management of thalassemia in Children.

Conclusion: Thalassemia has adverse effects for many organs and it has high morbidity without a cure. An interprofessional team that involves a thalassemia treatment manager, cardiologist, hepatologist, endocrinologist and psychologist may better treat the condition. Community treatment, health assistance and social service are also an important part of the management. Education of patients is crucial and participation of social workers, including a geneticist, is important. Preventive approaches in some parts of the world include prenatal screening, prohibitions on issuing marriage licenses to two individuals with the same disease. Screening of children and pregnant women visiting clinics is an important method to reduce morbidity of the disease. Finally, successful high school screening should be considered instead of premarital testing, as high school screening has been shown to be more effective in reducing the incidence of β-thalassemia.

Keywords: Thalassemia; Management of Thalassemia; Epidemiology of Thalassemia


  1. Joly P., et al. “[Beta-thalassemias: molecular, epidemiological, diagnostical and clinical aspects]”. Advances in Clinical Chemistry 6 (2014): 639-668.
  2. Ahmadpanah M., et al. “In Patients with Minor Beta-Thalassemia, Cognitive Performance Is Related to Length of Education, But Not to Minor Beta-Thalassemia or Hemoglobin Levels”. Iranian Journal of Psychiatry 1 (2019): 47-53.
  3. Vichinsky E., et al. “Epidemiologic and clinical characteristics of nontransfusion-dependent thalassemia in the United States”. Pediatr Blood Cancer7 (2018): e27067.
  4. Beck WS. “Hematology”. USA: The Massachusetts Institute of Technology (1998).
  5. Verma IC., et al. “Past, present and future scenario of thalassaemic care and control in India”. Indian Journal of Medical Research 134 (2011): 507-521.
  6. Bernaudin F., et al. “G6PD deficiency, absence of alpha-thalassemia, and hemolytic rate at baseline are significant independent risk factors for abnormally high cerebral velocities in patients with sickle cell anemia”. Blood 10 (2008): 4314-4317.
  7. Jalil T., et al. “Mutational Analysis of Beta Thalassaemia By Multiplex Arms-Pcr In Khyber Pakhtunkhwa, Pakistan”. Journal of Ayub Medical College Abbottabad 1 (2019): 98-103.
  8. Habibian N., et al. “Association between Iron Deficiency Anemia and Febrile Convulsion in 3- to 60-Month-Old Children: A Systematic Review and Meta-Analysis”. Iranian Journal of Medical Sciences 6 (2014): 496-505.
  9. Harteveld CL and Higgs DR. “α-thalassaemia”. Orphanet Journal of Rare Diseases 5 (2010): 13.
  10. Koren A., et al. “Prevention of beta thalassemia in Northern Israel: a cost-benefit analysis”. Mediterranean Journal of Hematology and Infectious Diseases 6 (2014): e2014012.
  11. Alswaidi FM and O’Brien SJ. “Premarital screening programmes for haemoglobinopathies, HIV and hepatitis viruses: review and factors affecting their success”. Journal of Medical Screening 16 (2009): 22-28.
  12. Olivieri NF., et al. “Hb E/beta-thalassaemia: a common and clinically diverse disorder”. Indian Journal of Medical Research 134 (2011): 522-531.
  13. Vichinsky EP. “Changing patterns of thalassemia worldwide”. Annals of the New York Academy of Sciences 1054 (2005): 18-24.
  14. Higgs DR., et al. “Thalassaemia”. Lancet 379 (2012): 373-383.
  15. Verma IC., et al. “Multicenter study of the molecular basis of thalassemia intermedia in different ethnic populations”. Hemoglobin 31 (2007): 439-452.
  16. Alamiry AAN., et al. “Detection of Hemoglobinopathies in Hypochromic, Microcytic and Sickeled Cell Blood Films by Hemoglobin Electrophoresis”. Thi-Qar Medical Journal 5 (2011): 139-148.
  17. ZA Memish and MY Saeedi. “Six-year outcome of the national premarital screening and genetic counseling program for sickle cell disease and beta-thalassemia in Saudi Arabia”. Annals of Saudi Medicine 3 (2011): 229-235.
  18. El-Beshlawy A and Youssry I. “Prevention of hemoglobinopathies in Egypt”. Hemoglobin 33 (2009): 14-20.
  19. Almutawa F and Alqamish J. “Prevalence of hemoglobinopathies among candidates attending premarital counseling in Bahrain”. Journal of the Bahrain Medical Society 20 (2008): 145-149.
  20. Hassan SM., et al. “Extended molecular spectrum of beta- and alpha-thalassemia in Oman”. Hemoglobin 34 (2010): 127-134.
  21. Baysal E. “Molecular basis of beta-thalassemia in the United Arab Emirates”. Hemoglobin 35 (2011): 581-588.
  22. Jain RC. “Sickle cell and thalassaemic genes in Libya”. Transactions of the Royal Society of Tropical Medicine and Hygiene 79 (1985): 132-133.
  23. Chouk I., et al. “Contribution to the description of the beta-thalassemia spectrum in Tunisia and the origin of mutation diversity”. Hemoglobin 28 (2004): 189-195.
  24. Boudrahem-Addour N., et al. “Molecular heterogeneity of beta-thalassemia in Algeria: how to face up to a major health problem”. Hemoglobin 33 (2009): 24-36.
  25. Tremblay C., et al. “Prevalence of haemoglobinopathy in sportsmen in Qatar”. British Journal of Sports Medicine 45 (2011): 317-324.
  26. Abu-Ghoush MW. “Subtypes of alpha thalassemia diagnosed at a Medical Center in Jordan”. TAF Preventive Medicine Bulletin 7 (2008): 373-376.
  27. El-Hazmi MAF. “Pre-marital examination as a method of prevention from blood genetic disorders. Community views”. Saudi Medical Journal 9 (2006): 1291-1295.
  28. Al Sulaiman A., et al. “Postmarital follow-up survey on high risk patients subjected to premarital screening program in Saudi Arabia”. Prenatal Diagnosis 5 (2010): 478-481.
  29. Alhamdan NA., et al. “Premarital screening for thalassemia and sickle cell disease in Saudi Arabia”. Genetics Medicine: Official J Am College Medical Genetics6 (2007): 372-377.
  30. Olivieri NF and Brittenham GM. “Management of the thalassemias”. Cold Spring Harbor Perspectives in Medicine 6 (2013): a011767.
  31. Darvishi Khezri H., et al. “Is Vitamin C Supplementation in Patients with β-Thalassemia Major Beneficial or Detrimental?” Hemoglobin 4 (2016): 293-294.
  32. Paul A., et al. “Cardiac involvement in beta-thalassaemia: current treatment strategies”. Postgraduate Medical Journal 4 (2019): 261-267.
  33. Waldmeier F., et al. “Pharmacokinetics, metabolism, and disposition of deferasirox in β-thalassemic patients with transfusion-dependent iron overload who are at pharmacokinetic steady state”. Drug Metabolism and Disposition 38 (2010): 808-816.
  34. Novartis Pharmaceuticals. Exjade (deferasirox) prescribing information (2010).
  35. Porter JB and Shah FT. “Iron overload in thalassemia and related conditions: Therapeutic goals and assessment of response to chelation therapies”. Hematology/Oncology Clinics of North America 24 (2010): 1109-1130.
  36. Cohen AR., et al. “Safety and effectiveness of long-term therapy with the oral iron chelator deferiprone”. Blood 102 (2003): 1583-1587.
  37. Gamberini MR., et al. “Hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism: Incidence and prevalence related to iron overload and chelation therapy in patients with thalassaemia major followed from 1980 to 2007 in the Ferrara Centre”. Pediatric Endocrinology Reviews 6 (2008): 158-169.
  38. Locatelli F., et al. “Outcome of patients with hemoglobinopathies given either cord blood or bone marrow transplantation from an HLA‐identical sibling”. Blood 122 (2013): 1072-1078.
  39. Li C., et al. “Related and unrelated donor transplantation for β thalassemia major: Results of an international survey”. Blood 132 (2018): 308.
  40. Locatelli F., et al. “Outcome of patients with hemoglobinopathies given either cord blood or bone marrow transplantation from an HLA‐identical sibling”. Blood 122 (2013): 1072-1078.
  41. Darvishi Khezri H., et al. “Is Vitamin C Supplementation in Patients with β-Thalassemia Major Beneficial or Detrimental?” Hemoglobin4 (2016): 293-294.
  42. Weatherall DJ. “The inherited diseases of hemoglobin are an emerging global health burden”. Blood 115 (2010): 4331-4336.
  43. Zurlo MG., et al. “Survival and causes of death in thalassaemia major”. Lancet 2 (1989): 27-30.
Citation: Raniyah Embarak D Alharbi., et al.. “Review on Thalassemia Epidemiology and Management in Children”. EC Microbiology 16.7 (2020): 66-71.

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