Blood transfusions therapy and frequency in beta thalassemia major patients

Beta thalassemia major children cannot make normal hemoglobin level needed to produce healthy red blood cells,and so they need regular blood transfusions.

Without regular blood transfusions support,about 85% of children with β-thalassemia major will die by 5 years of age.

Complications and side effects
The repeated blood transfusions have dangers and side effects like iron overload and contraction of transfusion-transmitted infections (TTI) such as HIV (with risk to evolve into AIDS),HBsAg,and HCV (with high risk of developing chronic hepatitis,liver cirrhosis and hepatocellular carcinoma),whose risks increases with the age of child and number of red cell transfusions done.
The risk of TTI has been cut down thanks to the screening immunodeficiency virus and hepatitis;anyway new events like West Nile Virus and babesiosis,which are not always screened for,may be in the the blood from asymptomatic donors.

It is a double-edged sword,and in India (and in general in South and Southeast Asia) beta thalassemia major patients seldom live more than 30 years.

When a pretransfusion Hb level > 9-10 g/dL is obtained,then the transfusions are given every month in the first years of age and then every 2-to-4 week. It usually starts in the first 2 years of age.

Hepatitis B vaccination is given before starting the transfusion treatment,as is hepatitis A vaccine when the child has the right age to do it.

Clinical record
To calculate the the annual blood requirements,it is necessary to keep track each time of the pretransfusion Hb level,the transfused blood,including the volume given and the haematocrit,and the child’s weight.

Blood Safety
It is very important that the transfused blood is of high quality,and the best donors have to be screened and chosen among regular voluntary,non-remunerated donors;it should be gathered and stored in a blood transfusion center.