Evaluation of haemotherapy in thalassaemias (20 years of Indian experience)

Two hundred fifty-one patients of beta-thalassaemia ranging from 3 months to 15 years of age were evaluated. They were maintained on hypertransfusion regimen and received periodic transfusions of group specific packed red cells. These multiple transfused patients were subjected to the tests for detection of transfusion malaria, HBsAg and allo-antibodies against red cells. Malaria infection and HBsAg were detected in 6.4% and 15.5% of patients respectively, while allo-antibodies were detected in 15.5% of patients. Thirteen patients (5.18%) developed hypersplenism and associated pressure symptoms due to splenomegaly for which they underwent splenectomy. Postsplenectomy period was uneventful and showed marked decrease in the frequency and quantitative requirements of transfusions and overall improvement in health. The continuing steady improvement of the prognosis in thalassaemia secondary to hypertransfusion regimen required us to transfer attention to other problems involved in thalassaemia management such as problems of hypersplenism and problems of multiple transfusion.