Clinical management of beta-thalassemia major.

Management of patients with beta-thalassemia is based on adequate, safe blood transfusions (free of transfusion-transmitted diseases) and prevention of iron overload. Iron overload causes multiple endocrinopathies, contributes to osteoporosis, and is the cause of cardiac disease. Cardiac disease, secondary to iron damage, causes death in developed countries as a result of noncompliance to deferoxamine from the third decade of life. In underdeveloped countries, cardiac death starts from 12 years of age, due to nonavailability of deferoxamine. With the emergence of the advanced cardiac magnetic resonance imaging technique, early diagnosis of heart iron will allow the currently available iron-chelating agents (oral and parenteral) to be used in an innovative way to improve the quality of life and improve survival of patients with beta-thalassemia. Copyright 2001 by W.B. Saunders Company.