“Maputla ka. Mukhang kulang ka sa iron,” often said in one breath which makes you think that pallor (maputla) or anemia (low red blood cells) is synonymous to iron deficiency. On the contrary, not all cases of anemia is secondary to lack of iron but may be inherited.
Thalassemia is a hereditary form of anemia presenting as pallor and often mistaken as iron deficiency anemia (nutritional anemia). Being an inherited red blood cell disorder, thalassemia is passed on from one generation to the next, from parents to their children.
In its most severe form (Thalassemia Major), patients have stunted growth, large spleens and bone deformities. Thalassemia Major patients are often diagnosed before their first birthday due to the development of anemia that is unresponsive to iron treatment. These patients are often born to unsuspecting, symptomless parents who are thalassemia carriers themselves.
Patients with Thalassemia Major would require regular, monthly red blood cell transfusion in order to survive. They likewise develop iron overload, a condition in which there is accumulation of toxic iron in the body brought about by the regular blood transfusion coupled with an enhanced ability to absorb iron in the gut.
This excessive body iron is lethal, damaging the heart, liver and endocrine system, often leading to heart and liver failure as well as complications of diabetes. To remove the deadly iron in the body, thalassemia patients need daily iron chelation treatment by slow subcutaneous (under the skin) infusion of Desferrioxamine or by the oral route using Desferasirox or Deferiprone.
Thalassemia screening starts with a simple blood count (CBC). Additional tests include hemoglobin electrophoresis found in some Metro Manila hospitals and the High Performance Liquid Chromatography (HPLC) for thalassemia, presently only being offered by the Philippine Thalassemia Study Group, National Institute of Health, Institute of Human Genetics, University of the Philippines, Manila.
Due to the lack of awareness and support for thalassemia, there is a pressing need for thalassemia families to have a supportive community that can provide a united voice for thalassemia patients in the country. Balikatang Thalassemia (Ba-Tha) was founded in 1993 by Doctors Alendry P. Caviles Jr. and Ernesto d’J Yuson together with the families of thalassemia patients to address these concerns. Ba-Tha through its volunteers and partners like the Thalassemia Center of the Philippines, the Philippine Society of Hematology and Blood Transfusion under the leadership of Dr. Angelina Mirasol, the Galloner’s Club headed by Col. Joel Torregoza and the Philippine Alliance of Patients Organizations led by Mrs. Fatima Lorenzo, are one in promoting thalassemia awareness and in organizing patient activities with the goal of improving the quality of care of thalassemia patients in the Philippines.
So the next time someone calls your attention because you look pale or you notice that the hemoglobin count in your CBC is lower than normal, instead of automatically popping an iron supplement, do yourself and your family a favor by having yourself screened for thalassemia.
Dr. Ma. Liza Naranjo is a pediatric hematologist and the secretary of Balikatang Thalassemia. The ONCOURAGE Health Information Advocacy promotes public awareness and continuing medical education on the prevention, detection and management of cancer and blood disorders. It is a collaboration between the Philippine Society of Medical Oncology, Philippine Society of Hematology and Blood Transfusion, Philippine Charity Sweepstakes Office, Philippine Foundation for Breast Care-Kasuso, Touched by Max Philippines, Balikatang Thalassemia and Novartis Oncology Philippines.