• She is diagnosed with thalassemia.
• Hb typing : E 77% F 23%
• Hemoglobinopathy and thalassemia
beta thalassemia/ Hemoglobin E
• Another boy in the thalassemia clinic has
different profile. He is sick and pale only whe
he has fever.
• Difference in severity of thalassemia’s
• Benefits of splenectomy
• The girl’s parents ask you if they can have
• Possibility of having another thalassemia
• She is transfused 3-4 times a year due to her
• Types of transfusion program
• Risks during transfusion
• The parents decided that they will not have
more babies, and asked for your opinion
about stem cell transplantation.
• Risk classification in stem cell transplantation
• Stem cell donor sources
• Cost effectiveness of stem cell
transplantation in thalassemia
• Stem cell donor cannot be found.
• She is put on hypertransfusion program.
• Risk and sequale of iron overload
• When to consider
• How to diagnose
• How to treat
• How to give advice
Comparison of iron chelators
• She did not received stem cell
transplantation. At the age of 20, she began
to experience recurrent pain in her RUQ of
• Others life events
Other complications from thalassemia
• Venous thromboembolism and
• Transfusion complication
– Post transfusion hypertension
– Transfusion reaction