<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.1006.524_s_001_w2aab3b7b1b1b6b1aab1c17b1Aa"><h3>Background</h3><p>Thalassemia is a common monogenic disease in Southeast Asia. Patients with transfusion-dependent thalassemia require frequent blood transfusions, which can lead to iron overload and subsequent organ dysfunction and damage. Iron overload is avoided by chelation therapy. There are 3 types of chelators available for iron chelation therapy, namely, desferrioxamine, deferiprone, and deferasirox. Although practical guidelines are available for the management of transfusion-dependent thalassemia, not all countries are able to provide “ideal” treatment for their patients.</p></sec><sec id="j_1905-7415.1006.524_s_002_w2aab3b7b1b1b6b1aab1c17b2Aa"><h3>Objectives</h3><p>To discuss the scope of iron chelation practices including the types of chelators that are available in Southeast Asia, and explore issues relevant to the treatment of transfusion-dependent thalassemic patients in this region.</p></sec><sec id="j_1905-7415.1006.524_s_003_w2aab3b7b1b1b6b1aab1c17b3Aa"><h3>Methods</h3><p>A literature search for information pertaining to thalassemia and its management from 2000 to 2015 was conducted using the following websites: PubMed/MEDLINE, Google Scholar, Scopus, and SpringerLink.</p></sec><sec id="j_1905-7415.1006.524_s_004_w2aab3b7b1b1b6b1aab1c17b4Aa"><h3>Results</h3><p>Not all Southeast Asian countries have yet published detailed information about their iron chelation practice and not all countries in Southeast Asia have uniform practices for thalassemia management based on published recommendations.</p></sec><sec id="j_1905-7415.1006.524_s_005_w2aab3b7b1b1b6b1aab1c17b5Aa"><h3>Conclusions</h3><p>Advances in treatment have improved the management of thalassemic patients. However, because of various issues, not all countries are able to provide an ideal treatment for their patients. Southeast Asian countries should work together to prevent this inherited disease.</p></sec></abstract>

BackgroundThalassemia is a common monogenic disease in Southeast Asia. Patients with transfusion-dependent thalassemia require frequent blood transfusions, which can lead to iron overload and subsequent organ dysfunction and damage. Iron overload is avoided by chelation therapy. There are 3 types of chelators available for iron chelation therapy, namely, desferrioxamine, deferiprone, and deferasirox. Although practical guidelines are available for the management of transfusion-dependent thalassemia, not all countries are able to provide “ideal” treatment for their patients.ObjectivesTo discuss the scope of iron chelation practices including the types of chelators that are available in Southeast Asia, and explore issues relevant to the treatment of transfusion-dependent thalassemic patients in this region.MethodsA literature search for information pertaining to thalassemia and its management from 2000 to 2015 was conducted using the following websites: PubMed/MEDLINE, Google Scholar, Scopus, and SpringerLink.ResultsNot all Southeast Asian countries have yet published detailed information about their iron chelation practice and not all countries in Southeast Asia have uniform practices for thalassemia management based on published recommendations.ConclusionsAdvances in treatment have improved the management of thalassemic patients. However, because of various issues, not all countries are able to provide an ideal treatment for their patients. Southeast Asian countries should work together to prevent this inherited disease.

Practice of iron chelation therapy for transfusion-dependent thalassemia in Southeast Asia

Department of Pediatrics, School of Medical Sciences

Department of Hematology, School of Medical Sciences

Department of Community Medicine, School of Medical Sciences

Department of Ophthalmology, School of Medical Sciences

Orthodontic Unit, School of Dental Sciences

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundThalassemia is a common monogenic disease in Southeast Asia. Patients with transfusion-dependent thalassemia require frequent blood transfusions,...

Policy/Service				Country
Malaysia	Thailand	Myanmar	Singapore	Indonesia	The Philippines	Vietnam	Cambodia
Iron chelation fees	Free [24, 66]	Partial free [54]	Not free [66]	Free [66]	Free [56, 66]	Not free [66]	Free [25]	Not free [25, 66]
National policy	Yes [24, 66]	Yes [66]	None [66]	Yes [66]	Yes[66]	None [66]	Yes [25]	None [66]
Patient registry	Yes [24, 66]	Yes (hospital based) [66]	Yes [56]	Yes [66]	Yes [56, 66]	Hematology association [66]	None [66]	Initiated [66]
Availability of counselling and prenatal diagnosis	Available [24, 66]	Available [66]	NA [56]	Available [66]	Available [56]	Limited [66]	Available [62]	No [66]
Stem cell transplantation	Yes [24]	Yes [66]	No [66]	Yes [69]	No [66]	No [66]	Yes [70]	No [66]
Magnetic resonance imaging	Available [24, 66]	Available [8]	NA [66]	Available [66]	Available [56, 66]	No [66]	None [66]	No [66]

Practice of iron chelation therapy for transfusion-dependent thalassemia in Southeast Asia

Article Category: Review article

Published Online: Mar 31, 2017

Page range: 537 - 547

DOI: https://doi.org/10.5372/1905-7415.1006.524

Keywords
Iron chelation therapy, practice, Southeast Asia, thalassemia

© 2016 Nurul Fatihah Azman, Wan-Zaidah Abdullah, Norsarwany Mohamad, Rosnah Bahar, Muhammad Farid Johan, R. Diana, Binti Hanafi Sarifah, Surini Yusoff, Ariffin Nasir, Azizah Othman, Surianti Sukeri, Mohd Ismail Ibrahim, Adil Hussein, Rozita Hassan, Padillah Yahya, Rosline Hassan, Bin Alwi Zilfalil

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Summary of thalassemia management in Southeast Asian countries.

Practice of iron chelation therapy for transfusion-dependent thalassemia in Southeast Asia

Article Category: Review article

Published Online: Mar 31, 2017

Page range: 537 - 547

DOI: https://doi.org/10.5372/1905-7415.1006.524

KeywordsIron chelation therapy, practice, Southeast Asia, thalassemia

© 2016 Nurul Fatihah Azman, Wan-Zaidah Abdullah, Norsarwany Mohamad, Rosnah Bahar, Muhammad Farid Johan, R. Diana, Binti Hanafi Sarifah, Surini Yusoff, Ariffin Nasir, Azizah Othman, Surianti Sukeri, Mohd Ismail Ibrahim, Adil Hussein, Rozita Hassan, Padillah Yahya, Rosline Hassan, Bin Alwi Zilfalil

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Summary of thalassemia management in Southeast Asian countries.

Keywords
Iron chelation therapy, practice, Southeast Asia, thalassemia