Skip to main content
Top
Published in: Drugs 15/2014

01-10-2014 | Therapy in Practice

Management of Non-Transfusion-Dependent Thalassemia: A Practical Guide

Authors: Ali T. Taher, Maria Domenica Cappellini

Published in: Drugs | Issue 15/2014

Login to get access

Abstract

Despite their transfusion-independence, non-transfusion-dependent thalassemia (NTDT) patients experience a variety of serious clinical complications that require prompt and comprehensive management. Transfusion therapy may still be an important part of management of this disease, in cases of acute stress, to support growth and development in childhood, or to prevent clinical morbidities stemming from ineffective erythropoiesis or hemolytic anemia. Although splenectomy is associated with improvements in hemoglobin levels, it leads to several short- and long-term adverse events, warranting caution in application of this intervention. Fetal hemoglobin induction therapy has been evaluated in non-randomized studies, with benefits extending beyond hematologic improvements to lowering morbidity risk. Effective and safe iron chelation therapy is now available for NTDT patients in whom iron overload develops, irrespective of transfusions, due to increased intestinal absorption, ultimately leading to clinically high iron burden levels and subsequent morbidity. Optimal management of NTDT patients requires a holistic approach targeting all hallmarks of the disease to ensure favorable patient outcomes.
Literature
1.
go back to reference Weatherall DJ, Clegg JB. The thalassaemia syndromes. 4th ed. Oxford: Blackwell Science; 2001.CrossRef Weatherall DJ, Clegg JB. The thalassaemia syndromes. 4th ed. Oxford: Blackwell Science; 2001.CrossRef
2.
go back to reference Steinberg MH, Forget BG, Higgs DR, Weatherall DJ. Disorders of hemoglobin : genetics, pathophysiology, and clinical management. Cambridge medicine. 2nd ed. New York: Cambridge University Press; 2009.CrossRef Steinberg MH, Forget BG, Higgs DR, Weatherall DJ. Disorders of hemoglobin : genetics, pathophysiology, and clinical management. Cambridge medicine. 2nd ed. New York: Cambridge University Press; 2009.CrossRef
5.
go back to reference Christianson A, Howson CP, Modell B. March of dimes global report on birth defects. New York: March of Dimes Brith Defects Foundation; 2006. Christianson A, Howson CP, Modell B. March of dimes global report on birth defects. New York: March of Dimes Brith Defects Foundation; 2006.
6.
7.
go back to reference Colah R, Gorakshakar A, Nadkarni A. Global burden, distribution and prevention of beta-thalassemias and hemoglobin E disorders. Expert Rev Hematol. 2010;3(1):103–17.PubMedCrossRef Colah R, Gorakshakar A, Nadkarni A. Global burden, distribution and prevention of beta-thalassemias and hemoglobin E disorders. Expert Rev Hematol. 2010;3(1):103–17.PubMedCrossRef
8.
go back to reference Weatherall DJ. Keynote address: The challenge of thalassemia for the developing countries. Ann N Y Acad Sci. 2005;1054:11–7.PubMedCrossRef Weatherall DJ. Keynote address: The challenge of thalassemia for the developing countries. Ann N Y Acad Sci. 2005;1054:11–7.PubMedCrossRef
9.
go back to reference Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79(8):704–12.PubMedPubMedCentral Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79(8):704–12.PubMedPubMedCentral
10.
go back to reference Olivieri NF, Pakbaz Z, Vichinsky E. HbE/beta-thalassemia: basis of marked clinical diversity. Hematol Oncol Clin North Am. 2010;24(6):1055–70.PubMedCrossRef Olivieri NF, Pakbaz Z, Vichinsky E. HbE/beta-thalassemia: basis of marked clinical diversity. Hematol Oncol Clin North Am. 2010;24(6):1055–70.PubMedCrossRef
11.
go back to reference Lorey F, Cunningham G, Vichinsky EP, Lubin BH, Witkowska HE, Matsunaga A, et al. Universal newborn screening for Hb H disease in California. Genet Test. 2001;5(2):93–100.PubMedCrossRef Lorey F, Cunningham G, Vichinsky EP, Lubin BH, Witkowska HE, Matsunaga A, et al. Universal newborn screening for Hb H disease in California. Genet Test. 2001;5(2):93–100.PubMedCrossRef
12.
go back to reference Lorey F. Asian immigration and public health in California: thalassemia in newborns in California. J Pediatr Hematol Oncol. 2000;22(6):564–6.PubMedCrossRef Lorey F. Asian immigration and public health in California: thalassemia in newborns in California. J Pediatr Hematol Oncol. 2000;22(6):564–6.PubMedCrossRef
13.
go back to reference Olivieri NF, Pakbaz Z, Vichinsky E. Hb E/beta-thalassaemia: a common & clinically diverse disorder. Indian J Med Res. 2011;134:522–31.PubMedPubMedCentral Olivieri NF, Pakbaz Z, Vichinsky E. Hb E/beta-thalassaemia: a common & clinically diverse disorder. Indian J Med Res. 2011;134:522–31.PubMedPubMedCentral
14.
go back to reference Cohen AR, Galanello R, Pennell DJ, Cunningham MJ, Vichinsky E. Thalassemia. Hematology Am Soc Hematol Educ Program;2004. 14–34. Cohen AR, Galanello R, Pennell DJ, Cunningham MJ, Vichinsky E. Thalassemia. Hematology Am Soc Hematol Educ Program;2004. 14–34.
15.
go back to reference Vichinsky E. Complexity of alpha thalassemia: growing health problem with new approaches to screening, diagnosis, and therapy. Ann N Y Acad Sci. 2010;1202:180–7.PubMedCrossRef Vichinsky E. Complexity of alpha thalassemia: growing health problem with new approaches to screening, diagnosis, and therapy. Ann N Y Acad Sci. 2010;1202:180–7.PubMedCrossRef
17.
go back to reference Michlitsch J, Azimi M, Hoppe C, Walters MC, Lubin B, Lorey F, et al. Newborn screening for hemoglobinopathies in California. Pediatr Blood Cancer. 2009;52(4):486–90.PubMedCrossRef Michlitsch J, Azimi M, Hoppe C, Walters MC, Lubin B, Lorey F, et al. Newborn screening for hemoglobinopathies in California. Pediatr Blood Cancer. 2009;52(4):486–90.PubMedCrossRef
18.
go back to reference Taher AT, Musallam KM, Karimi M, Cappellini MD. Contemporary approaches to treatment of beta-thalassemia intermedia. Blood Rev. 2012;26(Suppl 1):S24–7.PubMedCrossRef Taher AT, Musallam KM, Karimi M, Cappellini MD. Contemporary approaches to treatment of beta-thalassemia intermedia. Blood Rev. 2012;26(Suppl 1):S24–7.PubMedCrossRef
19.
go back to reference Taher A, Vichinsky E, Musallam K, Cappellini MD. Viprakasit V. In: Weatherall D, editor. Guidelines for the management of non transfusion dependent thalassaemia (NTDT). Cyprus: Nicosia; 2013. Taher A, Vichinsky E, Musallam K, Cappellini MD. Viprakasit V. In: Weatherall D, editor. Guidelines for the management of non transfusion dependent thalassaemia (NTDT). Cyprus: Nicosia; 2013.
21.
go back to reference Taher A, Isma’eel H, Cappellini MD. Thalassemia intermedia: revisited. Blood Cells Mol Dis. 2006;37(1):12–20.PubMedCrossRef Taher A, Isma’eel H, Cappellini MD. Thalassemia intermedia: revisited. Blood Cells Mol Dis. 2006;37(1):12–20.PubMedCrossRef
22.
go back to reference Cappellini MD, Musallam KM, Poggiali E, Taher AT. Hypercoagulability in non-transfusion-dependent thalassemia. Blood Rev. 2012;26(Suppl 1):S20–3.PubMedCrossRef Cappellini MD, Musallam KM, Poggiali E, Taher AT. Hypercoagulability in non-transfusion-dependent thalassemia. Blood Rev. 2012;26(Suppl 1):S20–3.PubMedCrossRef
23.
go back to reference Cappellini MD, Poggiali E, Taher AT, Musallam KM. Hypercoagulability in beta-thalassemia: a status quo. Expert Rev Hematol. 2012;5(5):505–11 quiz 12.PubMedCrossRef Cappellini MD, Poggiali E, Taher AT, Musallam KM. Hypercoagulability in beta-thalassemia: a status quo. Expert Rev Hematol. 2012;5(5):505–11 quiz 12.PubMedCrossRef
24.
go back to reference Musallam KM, Taher AT, Karimi M, Rachmilewitz EA. Cerebral infarction in beta-thalassemia intermedia: breaking the silence. Thromb Res. 2012;130(5):695–702.PubMedCrossRef Musallam KM, Taher AT, Karimi M, Rachmilewitz EA. Cerebral infarction in beta-thalassemia intermedia: breaking the silence. Thromb Res. 2012;130(5):695–702.PubMedCrossRef
25.
go back to reference Musallam KM, Cappellini MD, Wood JC, Taher AT. Iron overload in non-transfusion-dependent thalassemia: a clinical perspective. Blood Rev. 2012;26(Suppl 1):S16–9.PubMedCrossRef Musallam KM, Cappellini MD, Wood JC, Taher AT. Iron overload in non-transfusion-dependent thalassemia: a clinical perspective. Blood Rev. 2012;26(Suppl 1):S16–9.PubMedCrossRef
26.
go back to reference Taher AT, Musallam KM, El-Beshlawy A, Karimi M, Daar S, Belhoul K, et al. Age-related complications in treatment-naive patients with thalassaemia intermedia. Br J Haematol. 2010;150(4):486–9.PubMed Taher AT, Musallam KM, El-Beshlawy A, Karimi M, Daar S, Belhoul K, et al. Age-related complications in treatment-naive patients with thalassaemia intermedia. Br J Haematol. 2010;150(4):486–9.PubMed
27.
go back to reference Musallam KM, Cappellini MD, Daar S, Karimi M, El-Beshlawy A, Taher AT. Serum ferritin levels and morbidity in β-thalassemia intermedia: a 10-year cohort study [abstract]. Blood. 2012;120(21):1021. Musallam KM, Cappellini MD, Daar S, Karimi M, El-Beshlawy A, Taher AT. Serum ferritin levels and morbidity in β-thalassemia intermedia: a 10-year cohort study [abstract]. Blood. 2012;120(21):1021.
28.
go back to reference Musallam KM, Taher AT, Duca L, Cesaretti C, Halawi R, Cappellini MD. Levels of growth differentiation factor-15 are high and correlate with clinical severity in transfusion-independent patients with beta thalassemia intermedia. Blood Cells Mol Dis. 2011;47(4):232–4.PubMedCrossRef Musallam KM, Taher AT, Duca L, Cesaretti C, Halawi R, Cappellini MD. Levels of growth differentiation factor-15 are high and correlate with clinical severity in transfusion-independent patients with beta thalassemia intermedia. Blood Cells Mol Dis. 2011;47(4):232–4.PubMedCrossRef
29.
go back to reference Cazzola M, Finch CA. Evaluation of erythroid marrow function in anemic patients. Haematologica. 1987;72(3):195–200.PubMed Cazzola M, Finch CA. Evaluation of erythroid marrow function in anemic patients. Haematologica. 1987;72(3):195–200.PubMed
30.
go back to reference Cazzola M, Pootrakul P, Huebers HA, Eng M, Eschbach J, Finch CA. Erythroid marrow function in anemic patients. Blood. 1987;69(1):296–301.PubMed Cazzola M, Pootrakul P, Huebers HA, Eng M, Eschbach J, Finch CA. Erythroid marrow function in anemic patients. Blood. 1987;69(1):296–301.PubMed
31.
go back to reference Cazzola M, De Stefano P, Ponchio L, Locatelli F, Beguin Y, Dessi C, et al. Relationship between transfusion regimen and suppression of erythropoiesis in beta-thalassaemia major. Br J Haematol. 1995;89(3):473–8.PubMedCrossRef Cazzola M, De Stefano P, Ponchio L, Locatelli F, Beguin Y, Dessi C, et al. Relationship between transfusion regimen and suppression of erythropoiesis in beta-thalassaemia major. Br J Haematol. 1995;89(3):473–8.PubMedCrossRef
32.
go back to reference Taher AT, Musallam KM, Cappellini MD, Weatherall DJ. Optimal management of beta thalassaemia intermedia. Br J Haematol. 2011;152(5):512–23.PubMedCrossRef Taher AT, Musallam KM, Cappellini MD, Weatherall DJ. Optimal management of beta thalassaemia intermedia. Br J Haematol. 2011;152(5):512–23.PubMedCrossRef
33.
go back to reference Olivieri NF, Muraca GM, O’Donnell A, Premawardhena A, Fisher C, Weatherall DJ. Studies in haemoglobin E beta-thalassaemia. Br J Haematol. 2008;141(3):388–97.PubMedCrossRef Olivieri NF, Muraca GM, O’Donnell A, Premawardhena A, Fisher C, Weatherall DJ. Studies in haemoglobin E beta-thalassaemia. Br J Haematol. 2008;141(3):388–97.PubMedCrossRef
34.
go back to reference O’Donnell A, Premawardhena A, Arambepola M, Allen SJ, Peto TE, Fisher CA, et al. Age-related changes in adaptation to severe anemia in childhood in developing countries. Proc Natl Acad Sci USA. 2007;104(22):9440–4.PubMedPubMedCentralCrossRef O’Donnell A, Premawardhena A, Arambepola M, Allen SJ, Peto TE, Fisher CA, et al. Age-related changes in adaptation to severe anemia in childhood in developing countries. Proc Natl Acad Sci USA. 2007;104(22):9440–4.PubMedPubMedCentralCrossRef
35.
go back to reference Allen A, Fisher C, Premawardhena A, Peto T, Allen S, Arambepola M, et al. Adaptation to anemia in hemoglobin E-ss thalassemia. Blood. 2010;116(24):5368–70.PubMedCrossRef Allen A, Fisher C, Premawardhena A, Peto T, Allen S, Arambepola M, et al. Adaptation to anemia in hemoglobin E-ss thalassemia. Blood. 2010;116(24):5368–70.PubMedCrossRef
36.
37.
go back to reference Taher AT, Musallam KM, Karimi M, El-Beshlawy A, Belhoul K, Daar S, et al. Overview on practices in thalassemia intermedia management aiming for lowering complication rates across a region of endemicity: the OPTIMAL CARE study. Blood. 2010;115(10):1886–92.PubMedCrossRef Taher AT, Musallam KM, Karimi M, El-Beshlawy A, Belhoul K, Daar S, et al. Overview on practices in thalassemia intermedia management aiming for lowering complication rates across a region of endemicity: the OPTIMAL CARE study. Blood. 2010;115(10):1886–92.PubMedCrossRef
38.
39.
go back to reference Chou ST, Liem RI, Thompson AA. Challenges of alloimmunization in patients with haemoglobinopathies. Br J Haematol. 2012;159(4):394–404.PubMedCrossRef Chou ST, Liem RI, Thompson AA. Challenges of alloimmunization in patients with haemoglobinopathies. Br J Haematol. 2012;159(4):394–404.PubMedCrossRef
40.
go back to reference Musallam KM, Taher AT. Thrombosis in thalassemia: why are we so concerned? Hemoglobin. 2011;35(5–6):503–10.PubMedCrossRef Musallam KM, Taher AT. Thrombosis in thalassemia: why are we so concerned? Hemoglobin. 2011;35(5–6):503–10.PubMedCrossRef
41.
go back to reference Cappellini MD, Robbiolo L, Bottasso BM, Coppola R, Fiorelli G, Mannucci AP. Venous thromboembolism and hypercoagulability in splenectomized patients with thalassaemia intermedia. Br J Haematol. 2000;111(2):467–73.PubMedCrossRef Cappellini MD, Robbiolo L, Bottasso BM, Coppola R, Fiorelli G, Mannucci AP. Venous thromboembolism and hypercoagulability in splenectomized patients with thalassaemia intermedia. Br J Haematol. 2000;111(2):467–73.PubMedCrossRef
42.
go back to reference Taher AT, Musallam KM, Karimi M, El-Beshlawy A, Belhoul K, Daar S, et al. Splenectomy and thrombosis: the case of thalassemia intermedia. J Thromb Haemost. 2010;8(10):2152–8.PubMedCrossRef Taher AT, Musallam KM, Karimi M, El-Beshlawy A, Belhoul K, Daar S, et al. Splenectomy and thrombosis: the case of thalassemia intermedia. J Thromb Haemost. 2010;8(10):2152–8.PubMedCrossRef
43.
go back to reference Tavazzi D, Duca L, Graziadei G, Comino A, Fiorelli G, Cappellini MD. Membrane-bound iron contributes to oxidative damage of beta-thalassaemia intermedia erythrocytes. Br J Haematol. 2001;112(1):48–50.PubMedCrossRef Tavazzi D, Duca L, Graziadei G, Comino A, Fiorelli G, Cappellini MD. Membrane-bound iron contributes to oxidative damage of beta-thalassaemia intermedia erythrocytes. Br J Haematol. 2001;112(1):48–50.PubMedCrossRef
44.
go back to reference Taher A, Musallam KM, El Rassi F, Duca L, Inati A, Koussa S, et al. Levels of non-transferrin-bound iron as an index of iron overload in patients with thalassaemia intermedia. Br J Haematol. 2009;146(5):569–72.PubMedCrossRef Taher A, Musallam KM, El Rassi F, Duca L, Inati A, Koussa S, et al. Levels of non-transferrin-bound iron as an index of iron overload in patients with thalassaemia intermedia. Br J Haematol. 2009;146(5):569–72.PubMedCrossRef
45.
go back to reference Saad GS, Musallam KM, Taher AT. The surgeon and the patient with beta-thalassaemia intermedia. Br J Surg. 2011;98(6):751–60.PubMedCrossRef Saad GS, Musallam KM, Taher AT. The surgeon and the patient with beta-thalassaemia intermedia. Br J Surg. 2011;98(6):751–60.PubMedCrossRef
46.
go back to reference Musallam KM, Khalife M, Sfeir PM, Faraj W, Safadi B, Abi Saad GS, et al. Postoperative outcomes after laparoscopic splenectomy compared with open splenectomy. Ann Surg. 2013;257(6):1116–23.PubMedCrossRef Musallam KM, Khalife M, Sfeir PM, Faraj W, Safadi B, Abi Saad GS, et al. Postoperative outcomes after laparoscopic splenectomy compared with open splenectomy. Ann Surg. 2013;257(6):1116–23.PubMedCrossRef
47.
go back to reference Sankaran VG, Orkin SH. The switch from fetal to adult hemoglobin. Cold Spring Harb Perspect Med. 2013;3(1):a011643.PubMedCrossRef Sankaran VG, Orkin SH. The switch from fetal to adult hemoglobin. Cold Spring Harb Perspect Med. 2013;3(1):a011643.PubMedCrossRef
48.
go back to reference Musallam KM, Sankaran VG, Cappellini MD, Duca L, Nathan DG, Taher AT. Fetal hemoglobin levels and morbidity in untransfused patients with beta-thalassemia intermedia. Blood. 2012;119(2):364–7.PubMedCrossRef Musallam KM, Sankaran VG, Cappellini MD, Duca L, Nathan DG, Taher AT. Fetal hemoglobin levels and morbidity in untransfused patients with beta-thalassemia intermedia. Blood. 2012;119(2):364–7.PubMedCrossRef
49.
go back to reference Olivieri NF, Saunthararajah Y, Thayalasuthan V, Kwiatkowski J, Ware RE, Kuypers FA, et al. A pilot study of subcutaneous decitabine in beta-thalassemia intermedia. Blood. 2011;118(10):2708–11.PubMedPubMedCentralCrossRef Olivieri NF, Saunthararajah Y, Thayalasuthan V, Kwiatkowski J, Ware RE, Kuypers FA, et al. A pilot study of subcutaneous decitabine in beta-thalassemia intermedia. Blood. 2011;118(10):2708–11.PubMedPubMedCentralCrossRef
50.
go back to reference Musallam KM, Taher AT, Cappellini MD, Sankaran VG. Clinical experience with fetal hemoglobin induction therapy in patients with beta-thalassemia. Blood. 2013;121(12):2199–212 quiz 372.PubMedCrossRef Musallam KM, Taher AT, Cappellini MD, Sankaran VG. Clinical experience with fetal hemoglobin induction therapy in patients with beta-thalassemia. Blood. 2013;121(12):2199–212 quiz 372.PubMedCrossRef
51.
go back to reference Singer ST, Vichinsky EP, Sweeters N, Rachmilewitz E. Darbepoetin alfa for the treatment of anaemia in alpha- or beta- thalassaemia intermedia syndromes. Br J Haematol. 2011;154(2):281–4.PubMedCrossRef Singer ST, Vichinsky EP, Sweeters N, Rachmilewitz E. Darbepoetin alfa for the treatment of anaemia in alpha- or beta- thalassaemia intermedia syndromes. Br J Haematol. 2011;154(2):281–4.PubMedCrossRef
52.
go back to reference Loukopoulos D, Voskaridou E, Stamoulakatou A, Papassotiriou Y, Kalotychou V, Loutradi A, et al. Hydroxyurea therapy in thalassemia. Ann N Y Acad Sci. 1998;850:120–8.PubMedCrossRef Loukopoulos D, Voskaridou E, Stamoulakatou A, Papassotiriou Y, Kalotychou V, Loutradi A, et al. Hydroxyurea therapy in thalassemia. Ann N Y Acad Sci. 1998;850:120–8.PubMedCrossRef
53.
go back to reference Singer ST, Kuypers FA, Olivieri NF, Weatherall DJ, Mignacca R, Coates TD, et al. Fetal haemoglobin augmentation in E/beta(0) thalassaemia: clinical and haematological outcome. Br J Haematol. 2005;131(3):378–88.PubMedCrossRef Singer ST, Kuypers FA, Olivieri NF, Weatherall DJ, Mignacca R, Coates TD, et al. Fetal haemoglobin augmentation in E/beta(0) thalassaemia: clinical and haematological outcome. Br J Haematol. 2005;131(3):378–88.PubMedCrossRef
54.
go back to reference Platt OS, Orkin SH, Dover G, Beardsley GP, Miller B, Nathan DG. Hydroxyurea enhances fetal hemoglobin production in sickle cell anemia. J Clin Invest. 1984;74(2):652–6.PubMedPubMedCentralCrossRef Platt OS, Orkin SH, Dover G, Beardsley GP, Miller B, Nathan DG. Hydroxyurea enhances fetal hemoglobin production in sickle cell anemia. J Clin Invest. 1984;74(2):652–6.PubMedPubMedCentralCrossRef
55.
go back to reference Zeng YT, Huang SZ, Ren ZR, Lu ZH, Zeng FY, Schechter AN, et al. Hydroxyurea therapy in beta-thalassaemia intermedia: improvement in haematological parameters due to enhanced beta-globin synthesis. Br J Haematol. 1995;90(3):557–63.PubMedCrossRef Zeng YT, Huang SZ, Ren ZR, Lu ZH, Zeng FY, Schechter AN, et al. Hydroxyurea therapy in beta-thalassaemia intermedia: improvement in haematological parameters due to enhanced beta-globin synthesis. Br J Haematol. 1995;90(3):557–63.PubMedCrossRef
56.
go back to reference Singer ST, Vichinsky EP, Larkin S, Olivieri N, Sweeters N, Kuypers FA. Hydroxycarbamide-induced changes in E/beta thalassemia red blood cells. Am J Hematol. 2008;83(11):842–5.PubMedCrossRef Singer ST, Vichinsky EP, Larkin S, Olivieri N, Sweeters N, Kuypers FA. Hydroxycarbamide-induced changes in E/beta thalassemia red blood cells. Am J Hematol. 2008;83(11):842–5.PubMedCrossRef
57.
go back to reference Sripichai O, Makarasara W, Munkongdee T, Kumkhaek C, Nuchprayoon I, Chuansumrit A, et al. A scoring system for the classification of beta-thalassemia/Hb E disease severity. Am J Hematol. 2008;83(6):482–4.PubMedCrossRef Sripichai O, Makarasara W, Munkongdee T, Kumkhaek C, Nuchprayoon I, Chuansumrit A, et al. A scoring system for the classification of beta-thalassemia/Hb E disease severity. Am J Hematol. 2008;83(6):482–4.PubMedCrossRef
58.
go back to reference Amoozgar H, Farhani N, Khodadadi N, Karimi M, Cheriki S. Comparative study of pulmonary circulation and myocardial function in patients with beta-thalassemia intermedia with and without hydroxyurea, a case-control study. Eur J Haematol. 2011;87(1):61–7.PubMedCrossRef Amoozgar H, Farhani N, Khodadadi N, Karimi M, Cheriki S. Comparative study of pulmonary circulation and myocardial function in patients with beta-thalassemia intermedia with and without hydroxyurea, a case-control study. Eur J Haematol. 2011;87(1):61–7.PubMedCrossRef
59.
go back to reference Karimi M, Borzouee M, Mehrabani A, Cohan N. Echocardiographic finding in beta-thalassemia intermedia and major: absence of pulmonary hypertension following hydroxyurea treatment in beta-thalassemia intermedia. Eur J Haematol. 2009;82(3):213–8.PubMedCrossRef Karimi M, Borzouee M, Mehrabani A, Cohan N. Echocardiographic finding in beta-thalassemia intermedia and major: absence of pulmonary hypertension following hydroxyurea treatment in beta-thalassemia intermedia. Eur J Haematol. 2009;82(3):213–8.PubMedCrossRef
60.
go back to reference Karimi M, Mohammadi F, Behmanesh F, Samani SM, Borzouee M, Amoozgar H, et al. Effect of combination therapy of hydroxyurea with l-carnitine and magnesium chloride on hematologic parameters and cardiac function of patients with beta-thalassemia intermedia. Eur J Haematol. 2010;84(1):52–8.PubMedCrossRef Karimi M, Mohammadi F, Behmanesh F, Samani SM, Borzouee M, Amoozgar H, et al. Effect of combination therapy of hydroxyurea with l-carnitine and magnesium chloride on hematologic parameters and cardiac function of patients with beta-thalassemia intermedia. Eur J Haematol. 2010;84(1):52–8.PubMedCrossRef
61.
go back to reference Gamberini MR, Fortini M, De Sanctis V. Healing of leg ulcers with hydroxyurea in thalassaemia intermedia patients with associated endocrine complications. Pediatr Endocrinol Rev. 2004;2(Suppl 2):319–22.PubMed Gamberini MR, Fortini M, De Sanctis V. Healing of leg ulcers with hydroxyurea in thalassaemia intermedia patients with associated endocrine complications. Pediatr Endocrinol Rev. 2004;2(Suppl 2):319–22.PubMed
62.
go back to reference Suragani RN, Cadena SM, Cawley SM, Sako D, Mitchell D, Li R, et al. Transforming growth factor-beta superfamily ligand trap ACE-536 corrects anemia by promoting late-stage erythropoiesis. Nat Med. 2014;20(4):408–14.PubMedCrossRef Suragani RN, Cadena SM, Cawley SM, Sako D, Mitchell D, Li R, et al. Transforming growth factor-beta superfamily ligand trap ACE-536 corrects anemia by promoting late-stage erythropoiesis. Nat Med. 2014;20(4):408–14.PubMedCrossRef
63.
go back to reference Libani IV, Guy EC, Melchiori L, Schiro R, Ramos P, Breda L, et al. Decreased differentiation of erythroid cells exacerbates ineffective erythropoiesis in beta-thalassemia. Blood. 2008;112(3):875–85.PubMedPubMedCentralCrossRef Libani IV, Guy EC, Melchiori L, Schiro R, Ramos P, Breda L, et al. Decreased differentiation of erythroid cells exacerbates ineffective erythropoiesis in beta-thalassemia. Blood. 2008;112(3):875–85.PubMedPubMedCentralCrossRef
64.
go back to reference Melchiori L, Gardenghi S, Guy EG, Rachmilewitz E, Giardina PJ, Grady RW, et al. Use of JAK2 inhibitors to limit ineffective erythropoiesis and iron absorption in mice affected by β-thalassemia and other disorders of red cell production [abstract]. Blood. 2009;114(22):2020. Melchiori L, Gardenghi S, Guy EG, Rachmilewitz E, Giardina PJ, Grady RW, et al. Use of JAK2 inhibitors to limit ineffective erythropoiesis and iron absorption in mice affected by β-thalassemia and other disorders of red cell production [abstract]. Blood. 2009;114(22):2020.
65.
go back to reference Xu J, Peng C, Sankaran VG, Shao Z, Esrick EB, Chong BG, et al. Correction of sickle cell disease in adult mice by interference with fetal hemoglobin silencing. Science. 2011;334(6058):993–6.PubMedPubMedCentralCrossRef Xu J, Peng C, Sankaran VG, Shao Z, Esrick EB, Chong BG, et al. Correction of sickle cell disease in adult mice by interference with fetal hemoglobin silencing. Science. 2011;334(6058):993–6.PubMedPubMedCentralCrossRef
66.
go back to reference Cavazzana-Calvo M, Payen E, Negre O, Wang G, Hehir K, Fusil F, et al. Transfusion independence and HMGA2 activation after gene therapy of human beta-thalassaemia. Nature. 2010;467(7313):318–22.PubMedPubMedCentralCrossRef Cavazzana-Calvo M, Payen E, Negre O, Wang G, Hehir K, Fusil F, et al. Transfusion independence and HMGA2 activation after gene therapy of human beta-thalassaemia. Nature. 2010;467(7313):318–22.PubMedPubMedCentralCrossRef
67.
go back to reference Ginzburg Y, Rivella S. beta-thalassemia: a model for elucidating the dynamic regulation of ineffective erythropoiesis and iron metabolism. Blood. 2011;118(16):4321–30.PubMedPubMedCentralCrossRef Ginzburg Y, Rivella S. beta-thalassemia: a model for elucidating the dynamic regulation of ineffective erythropoiesis and iron metabolism. Blood. 2011;118(16):4321–30.PubMedPubMedCentralCrossRef
68.
go back to reference Musallam KM, Cappellini MD, Taher AT. Iron overload in beta-thalassemia intermedia: an emerging concern. Curr Opin Hematol. 2013;20(3):187–92.PubMedCrossRef Musallam KM, Cappellini MD, Taher AT. Iron overload in beta-thalassemia intermedia: an emerging concern. Curr Opin Hematol. 2013;20(3):187–92.PubMedCrossRef
69.
go back to reference Musallam KM, Cappellini MD, Daar S, Kairmi M, El-Beshlawy A, Graziadei G et al. Serum ferritin level and morbidity risk in transfusion-independent patients with beta-thalassemia intermedia: the ORIENT study. Haematologica. Epub 2014 Jul 4. Musallam KM, Cappellini MD, Daar S, Kairmi M, El-Beshlawy A, Graziadei G et al. Serum ferritin level and morbidity risk in transfusion-independent patients with beta-thalassemia intermedia: the ORIENT study. Haematologica. Epub 2014 Jul 4.
70.
go back to reference Lal A, Goldrich ML, Haines DA, Azimi M, Singer ST, Vichinsky EP. Heterogeneity of hemoglobin H disease in childhood. N Engl J Med. 2011;364(8):710–8.PubMedCrossRef Lal A, Goldrich ML, Haines DA, Azimi M, Singer ST, Vichinsky EP. Heterogeneity of hemoglobin H disease in childhood. N Engl J Med. 2011;364(8):710–8.PubMedCrossRef
71.
go back to reference Origa R, Barella S, Argiolas GM, Bina P, Agus A, Galanello R. No evidence of cardiac iron in 20 never- or minimally-transfused patients with thalassemia intermedia. Haematologica. 2008;93(7):1095–6.PubMedCrossRef Origa R, Barella S, Argiolas GM, Bina P, Agus A, Galanello R. No evidence of cardiac iron in 20 never- or minimally-transfused patients with thalassemia intermedia. Haematologica. 2008;93(7):1095–6.PubMedCrossRef
72.
go back to reference Taher AT, Musallam KM, Wood JC, Cappellini MD. Magnetic resonance evaluation of hepatic and myocardial iron deposition in transfusion-independent thalassemia intermedia compared to regularly transfused thalassemia major patients. Am J Hematol. 2010;85(4):288–90.PubMedCrossRef Taher AT, Musallam KM, Wood JC, Cappellini MD. Magnetic resonance evaluation of hepatic and myocardial iron deposition in transfusion-independent thalassemia intermedia compared to regularly transfused thalassemia major patients. Am J Hematol. 2010;85(4):288–90.PubMedCrossRef
73.
go back to reference Roghi A, Cappellini MD, Wood JC, Musallam KM, Patrizia P, Fasulo MR, et al. Absence of cardiac siderosis despite hepatic iron overload in Italian patients with thalassemia intermedia: an MRI T2* study. Ann Hematol. 2010;89(6):585–9.PubMedCrossRef Roghi A, Cappellini MD, Wood JC, Musallam KM, Patrizia P, Fasulo MR, et al. Absence of cardiac siderosis despite hepatic iron overload in Italian patients with thalassemia intermedia: an MRI T2* study. Ann Hematol. 2010;89(6):585–9.PubMedCrossRef
74.
go back to reference Mavrogeni S, Gotsis E, Ladis V, Berdousis E, Verganelakis D, Toulas P, et al. Magnetic resonance evaluation of liver and myocardial iron deposition in thalassemia intermedia and b-thalassemia major. Int J Cardiovasc Imaging. 2008;24(8):849–54.PubMedCrossRef Mavrogeni S, Gotsis E, Ladis V, Berdousis E, Verganelakis D, Toulas P, et al. Magnetic resonance evaluation of liver and myocardial iron deposition in thalassemia intermedia and b-thalassemia major. Int J Cardiovasc Imaging. 2008;24(8):849–54.PubMedCrossRef
75.
go back to reference Matta BN, Musallam KM, Maakaron JE, Koussa S, Taher AT. A killer revealed: 10-year experience with beta-thalassemia intermedia. Hematology. 2014;19(4):196–8.PubMedCrossRef Matta BN, Musallam KM, Maakaron JE, Koussa S, Taher AT. A killer revealed: 10-year experience with beta-thalassemia intermedia. Hematology. 2014;19(4):196–8.PubMedCrossRef
76.
go back to reference Musallam KM, Motta I, Salvatori M, Fraquelli M, Marcon A, Taher AT, et al. Longitudinal changes in serum ferritin levels correlate with measures of hepatic stiffness in transfusion-independent patients with beta-thalassemia intermedia. Blood Cells Mol Dis. 2012;49(3–4):136–9.PubMedCrossRef Musallam KM, Motta I, Salvatori M, Fraquelli M, Marcon A, Taher AT, et al. Longitudinal changes in serum ferritin levels correlate with measures of hepatic stiffness in transfusion-independent patients with beta-thalassemia intermedia. Blood Cells Mol Dis. 2012;49(3–4):136–9.PubMedCrossRef
77.
go back to reference Maakaron JE, Cappellini MD, Graziadei G, Ayache JB, Taher AT. Hepatocellular carcinoma in hepatitis-negative patients with thalassemia intermedia: a closer look at the role of siderosis. Ann Hepatol. 2013;12(1):142–6.PubMed Maakaron JE, Cappellini MD, Graziadei G, Ayache JB, Taher AT. Hepatocellular carcinoma in hepatitis-negative patients with thalassemia intermedia: a closer look at the role of siderosis. Ann Hepatol. 2013;12(1):142–6.PubMed
78.
go back to reference Musallam KM, Cappellini MD, Wood JC, Motta I, Graziadei G, Tamim H, et al. Elevated liver iron concentration is a marker of increased morbidity in patients with beta thalassemia intermedia. Haematologica. 2011;96(11):1605–12.PubMedPubMedCentralCrossRef Musallam KM, Cappellini MD, Wood JC, Motta I, Graziadei G, Tamim H, et al. Elevated liver iron concentration is a marker of increased morbidity in patients with beta thalassemia intermedia. Haematologica. 2011;96(11):1605–12.PubMedPubMedCentralCrossRef
79.
go back to reference Musallam KM, Cappellini MD, Taher AT. Evaluation of the 5 mg/g liver iron concentration threshold and its association with morbidity in patients with beta-thalassemia intermedia. Blood Cells Mol Dis. 2013;51(1):35-38. Musallam KM, Cappellini MD, Taher AT. Evaluation of the 5 mg/g liver iron concentration threshold and its association with morbidity in patients with beta-thalassemia intermedia. Blood Cells Mol Dis. 2013;51(1):35-38.
80.
go back to reference Ziyadeh FN, Musallam KM, Mallat NS, Mallat S, Jaber F, Mohamed AA, et al. Glomerular Hyperfiltration and Proteinuria in Transfusion-Independent Patients with beta-Thalassemia Intermedia. Nephron Clin Pract. 2012;121(3–4):c136–43.PubMedCrossRef Ziyadeh FN, Musallam KM, Mallat NS, Mallat S, Jaber F, Mohamed AA, et al. Glomerular Hyperfiltration and Proteinuria in Transfusion-Independent Patients with beta-Thalassemia Intermedia. Nephron Clin Pract. 2012;121(3–4):c136–43.PubMedCrossRef
81.
go back to reference Musallam KM, Beydoun A, Hourani R, Nasreddine W, Raad R, Koussa S, et al. Brain magnetic resonance angiography in splenectomized adults with beta-thalassemia intermedia. Eur J Haematol. 2011;87(6):539–46.PubMedCrossRef Musallam KM, Beydoun A, Hourani R, Nasreddine W, Raad R, Koussa S, et al. Brain magnetic resonance angiography in splenectomized adults with beta-thalassemia intermedia. Eur J Haematol. 2011;87(6):539–46.PubMedCrossRef
82.
go back to reference Musallam KM, Nasreddine W, Beydoun A, Hourani R, Hankir A, Koussa S, et al. Brain positron emission tomography in splenectomized adults with beta-thalassemia intermedia: uncovering yet another covert abnormality. Ann Hematol. 2012;91(2):235–41.PubMedCrossRef Musallam KM, Nasreddine W, Beydoun A, Hourani R, Hankir A, Koussa S, et al. Brain positron emission tomography in splenectomized adults with beta-thalassemia intermedia: uncovering yet another covert abnormality. Ann Hematol. 2012;91(2):235–41.PubMedCrossRef
83.
go back to reference Angelucci E, Brittenham GM, McLaren CE, Ripalti M, Baronciani D, Giardini C, et al. Hepatic iron concentration and total body iron stores in thalassemia major. N Engl J Med. 2000;343(5):327–31.PubMedCrossRef Angelucci E, Brittenham GM, McLaren CE, Ripalti M, Baronciani D, Giardini C, et al. Hepatic iron concentration and total body iron stores in thalassemia major. N Engl J Med. 2000;343(5):327–31.PubMedCrossRef
84.
go back to reference Wood JC. Impact of iron assessment by MRI. Hematology Am Soc Hematol Educ Program. 2011;2011:443–50.PubMedCrossRef Wood JC. Impact of iron assessment by MRI. Hematology Am Soc Hematol Educ Program. 2011;2011:443–50.PubMedCrossRef
85.
go back to reference Taher AT, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox reduces iron overload significantly in nontransfusion-dependent thalassemia: 1-year results from a prospective, randomized, double-blind, placebo-controlled study. Blood. 2012;120(5):970–7.PubMedCrossRef Taher AT, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox reduces iron overload significantly in nontransfusion-dependent thalassemia: 1-year results from a prospective, randomized, double-blind, placebo-controlled study. Blood. 2012;120(5):970–7.PubMedCrossRef
86.
go back to reference Pakbaz Z, Fischer R, Fung E, Nielsen P, Harmatz P, Vichinsky E. Serum ferritin underestimates liver iron concentration in transfusion independent thalassemia patients as compared to regularly transfused thalassemia and sickle cell patients. Pediatr Blood Cancer. 2007;49(3):329–32.PubMedCrossRef Pakbaz Z, Fischer R, Fung E, Nielsen P, Harmatz P, Vichinsky E. Serum ferritin underestimates liver iron concentration in transfusion independent thalassemia patients as compared to regularly transfused thalassemia and sickle cell patients. Pediatr Blood Cancer. 2007;49(3):329–32.PubMedCrossRef
87.
go back to reference Taher A, El Rassi F, Isma’eel H, Koussa S, Inati A, Cappellini MD. Correlation of liver iron concentration determined by R2 magnetic resonance imaging with serum ferritin in patients with thalassemia intermedia. Haematologica. 2008;93(10):1584–6.PubMedCrossRef Taher A, El Rassi F, Isma’eel H, Koussa S, Inati A, Cappellini MD. Correlation of liver iron concentration determined by R2 magnetic resonance imaging with serum ferritin in patients with thalassemia intermedia. Haematologica. 2008;93(10):1584–6.PubMedCrossRef
88.
go back to reference Origa R, Galanello R, Ganz T, Giagu N, Maccioni L, Faa G, et al. Liver iron concentrations and urinary hepcidin in beta-thalassemia. Haematologica. 2007;92(5):583–8.PubMedCrossRef Origa R, Galanello R, Ganz T, Giagu N, Maccioni L, Faa G, et al. Liver iron concentrations and urinary hepcidin in beta-thalassemia. Haematologica. 2007;92(5):583–8.PubMedCrossRef
89.
go back to reference Taher AT, Musallam KM, Viprakasit V, Porter JB, Cappellini MD. Iron chelation therapy for non-transfusion-dependent thalassemia (NTDT): a status quo. Blood Cells Mol Dis. 2014;52(2–3):88–90.PubMedCrossRef Taher AT, Musallam KM, Viprakasit V, Porter JB, Cappellini MD. Iron chelation therapy for non-transfusion-dependent thalassemia (NTDT): a status quo. Blood Cells Mol Dis. 2014;52(2–3):88–90.PubMedCrossRef
90.
go back to reference Taher AT, Viprakasit V, Musallam KM, Cappellini MD. Treating iron overload in patients with non-transfusion-dependent thalassemia. Am J Hematol. 2013;88(5):409–15.PubMedPubMedCentralCrossRef Taher AT, Viprakasit V, Musallam KM, Cappellini MD. Treating iron overload in patients with non-transfusion-dependent thalassemia. Am J Hematol. 2013;88(5):409–15.PubMedPubMedCentralCrossRef
91.
go back to reference Taher A, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Estimation of liver iron concentration by serum ferritin measurement in non-transfusion-dependent thalassemia patients: analysis from the 1-year THALASSA study [abstract]. Haematologica. 2012;96(S1):0927. Taher A, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Estimation of liver iron concentration by serum ferritin measurement in non-transfusion-dependent thalassemia patients: analysis from the 1-year THALASSA study [abstract]. Haematologica. 2012;96(S1):0927.
92.
go back to reference Taher A, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Serum ferritin for predicting clinically relevant LIC thresholds to guide management of patients with nontransfusion-dependent thalassemia treated with deferasirox: THALASSA study extension analysis [abstract]. Haematologica. 2013;98(S1):486. Taher A, Porter J, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Serum ferritin for predicting clinically relevant LIC thresholds to guide management of patients with nontransfusion-dependent thalassemia treated with deferasirox: THALASSA study extension analysis [abstract]. Haematologica. 2013;98(S1):486.
93.
go back to reference Cossu P, Toccafondi C, Vardeu F, Sanna G, Frau F, Lobrano R, et al. Iron overload and desferrioxamine chelation therapy in beta-thalassemia intermedia. Eur J Pediatr. 1981;137(3):267–71.PubMedCrossRef Cossu P, Toccafondi C, Vardeu F, Sanna G, Frau F, Lobrano R, et al. Iron overload and desferrioxamine chelation therapy in beta-thalassemia intermedia. Eur J Pediatr. 1981;137(3):267–71.PubMedCrossRef
94.
go back to reference Pippard MJ, Weatherall DJ. Iron balance and the management of iron overload in beta-thalassemia intermedia. Birth Defects Orig Artic Ser. 1988;23(5B):29–33.PubMed Pippard MJ, Weatherall DJ. Iron balance and the management of iron overload in beta-thalassemia intermedia. Birth Defects Orig Artic Ser. 1988;23(5B):29–33.PubMed
95.
go back to reference Ladis V, Berdousi H, Gotsis E, Kattamis A. Deferasirox administration for the treatment of non-transfusional iron overload in patients with thalassaemia intermedia. Br J Haematol. 2010;151(5):504–8.PubMedCrossRef Ladis V, Berdousi H, Gotsis E, Kattamis A. Deferasirox administration for the treatment of non-transfusional iron overload in patients with thalassaemia intermedia. Br J Haematol. 2010;151(5):504–8.PubMedCrossRef
96.
go back to reference Voskaridou E, Plata E, Douskou M, Papadakis M, Delaki EE, Christoulas D, et al. Treatment with deferasirox (Exjade) effectively decreases iron burden in patients with thalassaemia intermedia: results of a pilot study. Br J Haematol. 2010;148(2):332–4.PubMedCrossRef Voskaridou E, Plata E, Douskou M, Papadakis M, Delaki EE, Christoulas D, et al. Treatment with deferasirox (Exjade) effectively decreases iron burden in patients with thalassaemia intermedia: results of a pilot study. Br J Haematol. 2010;148(2):332–4.PubMedCrossRef
97.
go back to reference Akrawinthawong K, Chaowalit N, Chatuparisuth T, Siritanaratkul N. Effectiveness of deferiprone in transfusion-independent beta-thalassemia/HbE patients. Hematology. 2011;16(2):113–22.PubMedCrossRef Akrawinthawong K, Chaowalit N, Chatuparisuth T, Siritanaratkul N. Effectiveness of deferiprone in transfusion-independent beta-thalassemia/HbE patients. Hematology. 2011;16(2):113–22.PubMedCrossRef
98.
go back to reference Pootrakul P, Sirankapracha P, Sankote J, Kachintorn U, Maungsub W, Sriphen K, et al. Clinical trial of deferiprone iron chelation therapy in beta-thalassaemia/haemoglobin E patients in Thailand. Br J Haematol. 2003;122(2):305–10.PubMedCrossRef Pootrakul P, Sirankapracha P, Sankote J, Kachintorn U, Maungsub W, Sriphen K, et al. Clinical trial of deferiprone iron chelation therapy in beta-thalassaemia/haemoglobin E patients in Thailand. Br J Haematol. 2003;122(2):305–10.PubMedCrossRef
99.
go back to reference Rombos Y, Tzanetea R, Konstantopoulos K, Simitzis S, Zervas C, Kyriaki P, et al. Chelation therapy in patients with thalassemia using the orally active iron chelator deferiprone (L1). Haematologica. 2000;85(2):115–7.PubMed Rombos Y, Tzanetea R, Konstantopoulos K, Simitzis S, Zervas C, Kyriaki P, et al. Chelation therapy in patients with thalassemia using the orally active iron chelator deferiprone (L1). Haematologica. 2000;85(2):115–7.PubMed
100.
go back to reference Olivieri NF, Koren G, Matsui D, Liu PP, Blendis L, Cameron R, et al. Reduction of tissue iron stores and normalization of serum ferritin during treatment with the oral iron chelator L1 in thalassemia intermedia. Blood. 1992;79(10):2741–8.PubMed Olivieri NF, Koren G, Matsui D, Liu PP, Blendis L, Cameron R, et al. Reduction of tissue iron stores and normalization of serum ferritin during treatment with the oral iron chelator L1 in thalassemia intermedia. Blood. 1992;79(10):2741–8.PubMed
101.
go back to reference Chan JC, Chim CS, Ooi CG, Cheung B, Liang R, Chan TK, et al. Use of the oral chelator deferiprone in the treatment of iron overload in patients with Hb H disease. Br J Haematol. 2006;133(2):198–205.PubMedCrossRef Chan JC, Chim CS, Ooi CG, Cheung B, Liang R, Chan TK, et al. Use of the oral chelator deferiprone in the treatment of iron overload in patients with Hb H disease. Br J Haematol. 2006;133(2):198–205.PubMedCrossRef
102.
go back to reference Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox demonstrates a dose-dependent reduction in liver iron concentration and consistent efficacy across subgroups of non-transfusion-dependent thalassemia patients. Am J Hematol. 2013;88(6):503–6.PubMedPubMedCentralCrossRef Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox demonstrates a dose-dependent reduction in liver iron concentration and consistent efficacy across subgroups of non-transfusion-dependent thalassemia patients. Am J Hematol. 2013;88(6):503–6.PubMedPubMedCentralCrossRef
103.
go back to reference Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox effectively reduces iron overload in non-transfusion-dependent thalassemia (NTDT) patients: 1-year extension results from the THALASSA study. Ann Hematol. 2013;92(11):1485–93.PubMedPubMedCentralCrossRef Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Deferasirox effectively reduces iron overload in non-transfusion-dependent thalassemia (NTDT) patients: 1-year extension results from the THALASSA study. Ann Hematol. 2013;92(11):1485–93.PubMedPubMedCentralCrossRef
104.
go back to reference Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Approaching low liver iron burden in chelated patients with non-transfusion-dependent thalassemia: the safety profile of deferasirox. Eur J Haematol. 2014;92(6):521–6.PubMedCrossRef Taher AT, Porter JB, Viprakasit V, Kattamis A, Chuncharunee S, Sutcharitchan P, et al. Approaching low liver iron burden in chelated patients with non-transfusion-dependent thalassemia: the safety profile of deferasirox. Eur J Haematol. 2014;92(6):521–6.PubMedCrossRef
105.
go back to reference Gardenghi S, Ramos P, Marongiu MF, Melchiori L, Breda L, Guy E, et al. Hepcidin as a therapeutic tool to limit iron overload and improve anemia in beta-thalassemic mice. J Clin Invest. 2010;120(12):4466–77.PubMedPubMedCentralCrossRef Gardenghi S, Ramos P, Marongiu MF, Melchiori L, Breda L, Guy E, et al. Hepcidin as a therapeutic tool to limit iron overload and improve anemia in beta-thalassemic mice. J Clin Invest. 2010;120(12):4466–77.PubMedPubMedCentralCrossRef
106.
go back to reference Li H, Rybicki AC, Suzuka SM, von Bonsdorff L, Breuer W, Hall CB, et al. Transferrin therapy ameliorates disease in beta-thalassemic mice. Nat Med. 2010;16(2):177–82.PubMedCrossRef Li H, Rybicki AC, Suzuka SM, von Bonsdorff L, Breuer W, Hall CB, et al. Transferrin therapy ameliorates disease in beta-thalassemic mice. Nat Med. 2010;16(2):177–82.PubMedCrossRef
107.
go back to reference Guo S, Casu C, Gardenghi S, Booten S, Aghajan M, Peralta R, et al. Reducing TMPRSS6 ameliorates hemochromatosis and beta-thalassemia in mice. J Clin Invest. 2013;123(4):1531–41.PubMedPubMedCentralCrossRef Guo S, Casu C, Gardenghi S, Booten S, Aghajan M, Peralta R, et al. Reducing TMPRSS6 ameliorates hemochromatosis and beta-thalassemia in mice. J Clin Invest. 2013;123(4):1531–41.PubMedPubMedCentralCrossRef
Metadata
Title
Management of Non-Transfusion-Dependent Thalassemia: A Practical Guide
Authors
Ali T. Taher
Maria Domenica Cappellini
Publication date
01-10-2014
Publisher
Springer International Publishing
Published in
Drugs / Issue 15/2014
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-014-0299-0

Other articles of this Issue 15/2014

Drugs 15/2014 Go to the issue