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Samitivej Hospital Thalassemia and Hematology Center

Samitivej Hospital

Hematology is the study of the physiology of the blood and genetic blood disorders are common across the world. These can vary from being mild and easily controlled, to life-affecting and potentially fatal. The last global census on blood diseases showed that 280 million people have some sufferance degree of thalassemia and around 17,00 deaths.

Studies have shown areas of higher concentration of thalassemia, being; Southern Mediterranean, the Middle East, Southern Asia, and Africa. It is also apparent that sufferers with mild cases of thalassemia, akin to those of sickle cell anemia, have unusually high levels of protection against malaria. From an evolutionary viewpoint, this may indicate why these blood disorders are higher in the areas of the world where malaria is prevalent.

As a blood disorder, thalassemia is inherited and means that the sufferer has a reduced level of hemoglobin. It is hemoglobin that facilitates the red blood cells to carry oxygen around the body, essential for health and wellbeing. The disease creates excess levels of iron in the blood, which can result in both children and adults with severe thalassemia requiring regular blood transfusions. It may be necessary for patients to require a blood transfusion as regularly as every two weeks.

In the main, thalassemia can be categorized into two groups, alpha, and beta, with numerous subgroups of each. The disease can be carried by parents, unaware of its presence, and passed on to their children. It is also an extremely complex disorder that requires accurate diagnosis and specialist treatment by highly trained professionals.

Thalassemia Indicators

Common symptoms of thalassemia may include deformities of the facial bone structure and yellowing of the skin. Also common is abdominal swelling, dark urine, physical weakness, fatigue, and slow growth in children. Although it is possible that thalassemia may not be detected until later in life, sufferers would normally be diagnosed as a young child, by the age of two.

If a child is showing any signs of these indicators a professional examination and diagnosis are vital. Diagnosis at a dedicated hematology center should be sort due to the often misdiagnosis of the disease as being an iron deficiency. Thus, iron supplements may be prescribed, this is exactly the opposite of the treatment required for thalassemia which causes an excess of iron in the blood.

Treatment for Thalassemia

For those with mild cases of thalassemia daily life goes on largely unaffected. Folic acid supplementation is commonly prescribed along with dietary advice. Dietary knowledge and awareness is a key weapon for the mild, or more extreme, sufferer. It is vital that sufferers ensure their food and drink intake is both nutritional and low in iron.

Those that are thalassemic should avoid a diet that is fortified in iron. Foods rich in vitamin C are to be avoided along with leafy green vegetables, red meat, and cereals. Many pulses are also high in iron content, such as kidney beans, chickpeas, and soybeans. For children under ten years of age, iron intake should be kept below 10 milligrams per day, for older children, below 18 milligrams per day.

Root vegetables tend to be low in iron as are chicken, turkey, and bananas, and the iron content in dairy products is negligible. Modern food packaging gives vital information on the food content. Patients with thalassemia should be aware of the information provided on food packaging to monitor their daily iron intake.

There are several treatment options for moderate to severe thalassemia. With the body’s inability to maintain the correct levels of iron, sufferers will often require regular blood transfusions. The transfusions would normally be every two or three weeks. However, over time, this can actually cause a build-up of iron which then endangers the health and functioning of the body’s internal organs.

As the iron increases due to the blood transfusions, chelation therapy will be introduced to remove the excess iron. This long-standing procedure is the administration of chelating agents which remove heavy metals from the body. Oral medication, such as deferasirox or deferiprone, or an injected drug such as deferoxamine are common as part of chelation therapy. It is fair to say that blood transfusion and chelation therapy are necessary bedfellows.

Curing Thalassemia

Since being identified in 1925 by an American physician, Thomas Cooley, generations have had to look upon thalassemia as sufferance that simply had to be lived with. But now, with today’s medical advances, it is possible to rid sufferers of the disease. This is now being done with bone marrow and stem cell transplants.

Although this is a relatively new procedural cure for thalassemia, the statistics are very good and encouraging. Success rates are between 80% and 90% with procedural mortality at no more than 3%. This treatment is the only known possible cure and thalassemia patients should only seek advice from an accredited thalassemia and hematology center.

Bone marrow and stem cell transplants require a fully matched donor, but for very young patients there is also the option of haploidentical bone marrow and stem cell transplant. This is an allogeneic transplant that uses healthy blood-creating cells from the donor which is half-matched. The donor would normally be a family member.

For Advice, Diagnosis and Treatment

Samitivej Hospital understands the complexities and challenges that thalassemia presents to both patients and physicians, and the importance of having a professional team to tackle the multi-faceted problems associated with the disease. Thus, they have created their dedicated Thalassemia and Hematology Center.

The center aims to diagnose thalassemia early in patients to maximize the success of treatments and cures. To do this it employs modern, state of the art equipment and procedures, in both diagnostics and treatment. The highly trained team of pediatric professionals is second to none and is headed up by professor Suradeg Hongeng, M.D. The center and its team are world leaders in the field of thalassemia and hematology.

The Samitivej team will also give advice and guidance on diet and lifestyle which is essential for thalassemia sufferers to lead an as normal and fulfilling life as possible. With a multi-lingual team, the center diagnoses and treats patients both indigenous and those from overseas. Samitivej Hospital Thalassemia and Hematology Center is now recognized as a world leader in the field.

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