Transfusions in Thalassemia: What Every Family Should Know

Why Are Transfusions Needed?

Children with Transfusion-Dependent Thalassemia (TDT) cannot produce enough healthy hemoglobin. Regular transfusions maintain hemoglobin at 9–10.5 g/dL, supporting growth, brain development, and heart health.

How Often Are Transfusions Given?

Most children need blood every 3–4 weeks. The schedule may vary slightly based on growth, illness, and pre-transfusion hemoglobin.

Safe Blood Requirements

Every child with thalassemia should receive:

• NAAT-tested blood (early detection of HIV, HBV, HCV)
• Leucodepleted blood (reduces fever reactions, CMV transmission, and HLA alloimmunization)
• Extended crossmatched blood (Rh, Kell, Duffy, Kidd, MNS antigens matched to avoid antibodies)

Signs Parents Should Watch During Transfusion

Fever, chills, rashes, difficulty breathing, dark urine, vomiting, or back pain. Report immediately.

Iron Overload

Each transfusion adds iron that accumulates in organs. Excess iron affects the heart, liver, hormones, and bones. Chelation therapy (Deferasirox, Deferiprone, Deferoxamine) removes excess iron.

Monitoring Schedule

• Ferritin every 3 months
• MRI T2* (heart & liver) every 1–2 years
• Thyroid, sugar, hormone tests yearly
• Growth and puberty check-ups
• Bone health assessment

Making Transfusions Easier

Maintain a transfusion diary, track hemoglobin, hydrate well, continue normal activities and school whenever possible.

Curative Options

Stem Cell Transplant (HSCT) and gene therapy are the only curative treatments.