[Clinical management of thalassemia in adults]

The clinical management of patients with thalassemia has changed in the last 40 years. Increasing knowledge of the underlying pathophysiology of the disease, as well as the introduction of modern transfusion policies, together with a consequent iron-chelation strategy, clearly improves the life expectancy for patients with thalassemia. Nowadays children with correctly treated thalassemia major will survive to adulthood. As a consequence emerging complications are expected. The management of symptomatic thalassemia requires a highly specialized multidisciplinary healthcare provider team where the hematologist plays a central role. General practitioners will be more frequently involved in thalassemia patient handling. In this manuscript we will focus on the most relevant complications such are iron overload, bone complications, extramedullary hematopoiesis, hypercoagulability, impaired fertility and pregnancy.