What is thalassaemia: Causes, symptoms, and solutions for safe blood transfusions in patients

Do you know that thousands of Thalassaemia patients struggle each month, not just with the disease itself, but with finding safe, compatible blood? For people with transfusion-dependent Thalassaemia (TDT), regular blood transfusions are life-saving.

Thalassaemia is a genetic blood disorder that affects the body’s ability to make hemoglobin, the protein in red blood cells that carries oxygen. According to the National Heart, Lung, and Blood Institute (NHLBI), it’s passed down from parents and can range from mild to severe depending on the type and number of faulty genes involved.

There are two main types, alpha and beta Thalassaemia, based on which part of the hemoglobin is affected. People with Thalassaemia may feel tired, weak, look pale or yellowish, grow slowly, or have dark urine. In more serious cases, it can cause bone changes and swelling in the belly from an enlarged spleen or liver.

Also read | Decoding myths and facts related to this blood disorder

Mild cases might go unnoticed, but severe Thalassaemia often shows up in early childhood and usually needs regular blood transfusions or a bone marrow transplant to manage it.

Thalassaemia presents a range of complex challenges. With shortages, improper matching, and limited safety protocols, the challenges are complex, but not insurmountable, says Dr Sunil Bhat Vice Chairman, Oncology Collegium, Narayana Health Group. Director and Clinical Lead, Head of the Department, Pediatric Hematology, Oncology, Clinical Immunology and Bone Marrow (Stem Cell) Transplantation, Narayana Health City, Bengaluru. “Thalassaemia is a severe genetic blood disorder that impairs the body’s ability to produce normal haemoglobin. For patients with TDT, survival depends on regular red blood cell transfusions,” he says.

However, according to Dr. Bhat, in many regions, maintaining the recommended pre-transfusion haemoglobin levels of 9–10 g/dL is nearly impossible. “The shortfall in safe and timely transfusions can lead to serious complications like growth delays, heart issues, and even early death. When haemoglobin levels drop below 7 g/dL due to blood shortages, he shares, it results in oxygen deprivation and long-term damage to vital organs,” he adds.

Dr Bhat shares the key challenges and suggests solutions for safe blood transfusions in Thalassaemia patients:

• Blood supply inconsistency: Blood services in many countries rely too much on family or replacement donors, leading to inconsistent blood availability and poor safety standards.

Solution: Centralising blood services to create standardised practices and improve tracking of blood inventories.

• Inadequate blood testing: Fragmented blood collection systems and inconsistent testing protocols worsen the situation, making it harder to ensure blood safety and proper matching.

Solution: Improving testing procedures and ensuring better traceability for every unit of blood donated.

• Alloimmunisation risks: Frequent blood transfusions can lead to alloimmunisation, where the body rejects foreign red cell antigens, making future transfusions more difficult.

Solution: Expanding antigen matching through advanced phenotyping and building comprehensive donor registries to avoid complications for sensitized patients.

• Limited donor awareness: A lack of awareness and education about blood donation means many regions struggle to maintain a steady, safe donor base.

Solution: Raising awareness and educating the public to encourage voluntary blood donation, especially for children in need of regular transfusions.

• Impact of emergencies: In times of crisis such as pandemics, conflicts, or natural disasters, donation rates drop sharply, making it even harder to meet the needs of thalassemia patients.

Solution: Developing predictive logistics and emergency systems that use technology to forecast demand and manage blood stocks more efficiently.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.