When To Begin Transfusion Therapy
Transfusion therapy should only begin once a diagnosis of thalassaemia major is confirmed. A confirmed diagnosis of Thalassaemia major is based on:
• laboratory test
• genetic analysis
The severity of anaemia is usually assessed on the basis of levels of haemoglobin (Hb) in the blood. This is measured in grams (g) per decilitre (dI - 1/100 th of a litre) of blood. A normal Hb level is generally considered to be between 13-16g/dI in men and 11/14g/dI in woman and children. In both men and women, haemoglobin levels of between 8-11g/dI represent moderate anaemia, with severe anaemia at levels less than 8g/dI.
Patients should only begin transfusion therapy once thalassaemia has been confirmed and when:
* Hb levels are registered at less than 7g/dl on two successive occasions. Paients may thrive and grow normally with Hb values between 6-7g/dl but a decision not to transfuse under these circumstances requires great clinical experience and careful observation.
Important Note
* Hb levels are >7g/dl but accompanying physical characteristics are noted, such as:
-facial changes
-poor growth and limited weight gain
-bone fractures
-extra-medullar hematopoiesis, resulting in tumor masses.
Where these criteria are observed, transfusion therapy should not be delayed.
