Epidemiological situation and treatment of patients with thalassemia majorin Germany: results of the German multicenter beta-thalassemia study

At present, about 300 patients in Germany suffer from thalassemia major. In 1990, a multicenter study was introduced to identify all thalassemic patie nts in Germany as well as to establish a uniform therapy protocol, includin g follow-up diagnostic procedures. After 6 years of study, the data of 203 patients were analyzed. The majority originate from endemic regions around the Mediterranean Sea. The median age of the patients is 13.8 years (range 1-37.5 years). At present, about 20% of the patients are older than 21 year s. Regarding transfusion therapy, a shortening of the average transfusion i nterval to 3 weeks in most cases occurred. Throughout the entire period, me dian baseline hemoglobin concentrations of 10.0 g/dl were observed. The eva luation of serum ferritin levels revealed considerable differences, dependi ng on the patients' age. Thalassemic patients in the first decade of life g enerally presented with good therapeutic results; serum ferritin levels wer e below 1800 ng/ml in 76/102 patients (75%) upon entry into the study. In c ontrast, 51/98 patients (52%) older than 10 years had ferritin levels above 2500 ng/ml. More than half of all treated patients presented with sideroti c complications such as cardiac disease in 20/157 (13%), liver disease in 3 2/157 (21%), impaired glucose metabolism in 22/157 (14%), hypogonadism in 3 9/66 (59%), and hypothyroidism in 38/157 (24%) who were under treatment at the time of first survey. Since the situation concerning siderosis and the lack of compliance proved to be particularly difficult with adolescent pati ents, further efforts should concentrate on this age-group.