COMPLICATIONS OF TDT
What are some complications that can occur in people living with transfusion-dependent thalassemia (TDT)?
Click on the icons to learn more about each complication:
Blood clots
Several things that happen in thalassemia can add up to you getting a dangerous blood clot that lodges in a blood vessel, where it can cause a block in the heart or a stroke in the brain. For patients who do not receive regular transfusions, this can be more common.
Brittle bones
Most blood cells are made in the bone marrow (the spongy material inside bones). In patients with thalassemia, it can expand due to increased demand for red blood cells, which causes your bones to widen. This can make your bones thin and brittle, increasing the chance of broken bones.
Iron overload
People with thalassemia who receive regular transfusions, as well as those who do not receive regular transfusions, can get too much iron in their bodies either from frequent blood transfusions or the disease.
This means a lot of iron is moving around in the blood. When iron builds up, it collects in places like the heart, liver, and endocrine organs and can make it hard for these organs to work properly.
Leg ulcers
Anemia results in reduced oxygen delivery to tissues like the skin, making it easier for ulcers, or sores, to develop.
Liver disease
When iron deposits into the liver, it can lead to fibrosis (scarring of the liver) and cirrhosis (severe scarring, which can prevent proper functioning).
Low production of hormones
Hormones are chemicals the body produces and uses to regulate almost every organ and function. Due to anemia or iron overload, thalassemia can result in lower production of certain hormones. This can be associated with a number of conditions, including growth delays, delayed puberty, thyroid problems, and diabetes.
Production of blood cells outside the bone marrow
This can occur in all types of thalassemia when red blood cells are not produced properly in the bone marrow. This can lead to enlargement of organs such as the spleen and liver.
Pulmonary hypertension
A type of high blood pressure in the lungs. The breakdown of red blood cells (hemolysis) can cause it, and so can iron overload.
This is not a complete list of possible complications. For medical advice, please consult with your doctor.
Many thalassemia complications result from chronic anemia. Some complications can lead to end-organ damage and can be life-threatening if not properly monitored and managed.
Monitoring helps you and your care team identify problems and prevent them from becoming worse. to help keep track of your thalassemia.
What are the ongoing challenges of TDT despite blood transfusions?
- While one goal of blood transfusions is to reduce the risk of thalassemia complications, people who receive transfusions can still experience them. These complications can be caused by either the thalassemia itself or by the blood transfusions
- In a 10-year study of people with beta-TDT, 76% developed at least 1 complication*
- In beta-TDT, greater transfusion burden (defined as more frequent transfusions or more units transfused) is associated with more complications
- While there are limited studies in people with alpha-TDT, those with alpha-TDT may experience complications similar to those with beta-TDT
*
In this study, 612 people living with TDT were followed from their first hospital admission or outpatient appointment in 2009 until death in hospital, last hospital admission, or last outpatient appointment in 2018.
Impact of transfusions on daily life
~
10
Hours
Total reported time spent on transfusion-related activities on transfusion days†
~
1.5
Hours
Total reported time spent on transfusion-related activities on non-transfusion days†
†
Study design: In this study, 81 adults living with beta-TDT and 4 caregivers of adolescents living with beta-TDT provided data using a smartphone application. Data included information about their health-related quality of life, symptoms, and TDT management over a period of 90 days.
People with TDT can experience a substantial impact on quality of life and work productivity. The ability to reduce the number of transfusions or the number of units transfused may help reduce the burden of transfusions.
It’s important for you to monitor your thalassemia
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