The pattern of bone disease in transfusion-dependent thalassemia major patients.

Twenty-eight patients with thalassemia major were treated with frequent blood transfusions for 10-25 years. Eleven (39%) had radiographic signs of osteoporosis, and four (14%) presented with fractures. Keeping hemoglobin level above 9.0 g/dl reduced osteoporosis and the incidence of fractures but did not prevent them. Osteonecrosis of the femoral head and distal femur, not previously reported, was noted in two patients.