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

Background: Thalassemia is a common monogenic disease in Southeast Asia. Patients with transfusiondependent 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 chelatorsavailable 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 treatment for their patients. Objectives: 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. Methods: 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. Results: 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. Conclusions: 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. Keywords: Iron chelation therapy, practice, Southeast Asia, thalassemia