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Review

Non-Transfusion Dependent Thalassemia: Translating Evidence to Guidelines

Division of Hematology & Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Thalass. Rep. 2014, 4(3), 4863; https://doi.org/10.4081/thal.2014.4863
Submission received: 4 October 2014 / Revised: 4 November 2014 / Accepted: 4 November 2014 / Published: 4 December 2014

Abstract

The thalassemias are a group of inherited disorders of hemoglobin synthesis characterized by various degrees of defective production of the α- or β-globin chains of adult hemoglobin A. Non-transfusion- dependent thalassemia (NTDT) includes a group of thalassemia patients who do not require regular RBC transfusions for survival, but may require occasional transfusions due to infection or pregnancy or may require more regular transfusions later in life due to splenomegaly or other complications. Due to the rising phenomenon of global migration, this previously well-localized entity is currently spreading more and more worldwide reaching Northern America and Northern Europe. The clinical picture of NTDT is governed by the severity of the ineffective erythropoiesis and the chronic hemolytic anemia, which, in turn, lead to iron overload, hypercoagulability, and an array of clinical complications involving almost every organ system. Patients with NTDT suffer from complications that are distinct from those encountered in patients with transfusion- dependent thalassemia (TDT) in addition to the complications shared by both TDT and NTDT. As a consequence, patients with NTDT deserve a care specifically tailored to their needs. In the care of patients with NTDT, aiming at a standardized yet personalized care is not an easy task especially that NTDT patients lie on a heterogeneous spectrum with a wide variability in their clinical presentation and response to therapy. Therefore, guidelines emerge as a necessity to answer the specific needs of NTDT patients and the clinicians caring for them. In this article, we summarize the complications most commonly associated with NTDT and the recommendations of the guidelines for the management of patients with NTDT, based on the best available evidence.
Keywords: thalassemia; hemoglobin a; transfusion; chronic hemolytic anemia; erythropoiesis thalassemia; hemoglobin a; transfusion; chronic hemolytic anemia; erythropoiesis

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MDPI and ACS Style

Harb, A.R.; Saliba, A.N.; Taher, A.T. Non-Transfusion Dependent Thalassemia: Translating Evidence to Guidelines. Thalass. Rep. 2014, 4, 4863. https://doi.org/10.4081/thal.2014.4863

AMA Style

Harb AR, Saliba AN, Taher AT. Non-Transfusion Dependent Thalassemia: Translating Evidence to Guidelines. Thalassemia Reports. 2014; 4(3):4863. https://doi.org/10.4081/thal.2014.4863

Chicago/Turabian Style

Harb, Afif R., Antoine N. Saliba, and Ali T. Taher. 2014. "Non-Transfusion Dependent Thalassemia: Translating Evidence to Guidelines" Thalassemia Reports 4, no. 3: 4863. https://doi.org/10.4081/thal.2014.4863

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