Intermittent Transfusions for Treatment of Thalassemia in the State of Georgia, 2007-2016

Rapid Communication

Ann Hematol Oncol. 2021; 8(4): 1340.

Intermittent Transfusions for Treatment of Thalassemia in the State of Georgia, 2007-2016

Rollins MR1,2*, Boudreaux J2, Eckman J3, Branscomb J4, Zhou M4 and Snyder A4

1Department of Pathology, Emory University, USA

2Department of Pediatrics, Emory University, USA

3Department of Hematology & Oncology, Emory University, USA

4Georgia State University, Andrew Young School of Policy Studies, USA

*Corresponding author: Margo R Rollins, Department of Pathology, Emory University, School of Medicine, Center for Transfusion and Cellular Therapies, Emory University, 1001 Johnson Ferry RD, NE, Atlanta, Georgia 30342, USA

Received: March 04, 2021; Accepted: April 03, 2021; Published: April 10, 2021


Background: Individuals with Non-Transfusion Dependent Thalassemia (NTDT) may require infrequent transfusions. Knowing transfusion history, while important, can be challenging in this subgroup.

Study Design: Hospital discharge data in Georgia (2007-2016) was reviewed. Thalassemia patients were defined as ≥3 encounters with a thalassemia diagnosis code. Transfusion was defined by the presence of a diagnosis, CPT, revenue, or HCPCS code for red cell transfusion.

Results: There were 428 patients identified; 57 received multi-site transfusions.

Conclusion: Georgia hospitals provide intermittent transfusions to low volumes of probable NTDT patients. Patient and provider education may help assure adherence to best practices, avoiding serious transfusion complications.

Keywords: Non-transfusion dependent thalassemia; Transfusion complications; Thalassemia diagnosis


Thalassemia is a group of autosomal recessive hemoglobinopathies with high prevalence in populations originating from the Mediterranean, Middle East, and Southeast Asia [1,2]. Alpha and beta-thalassemia are molecularly heterogeneous resulting in a spectrum of phenotypic manifestations.

Two phenotypes determined by the degree of transfusion dependence define thalassemia [3]. Individuals with Transfusion Dependent Thalassemia (TDT) require life-long regular transfusions. Individuals with Non-Transfusion Dependent Thalassemia (NTDT) generally require infrequent or no transfusions, often diagnosed later in life. Although transfusion requirements may differ between TDT and NTDT, the risk for disease-related complications (hemosiderosis and alloimmunization) exist across both groups [4].

While individuals with TDT are cared for in either a hematologyoncology practice or recognized Thalassemia Treatment Center (TTC), characterization of care for NTDT individuals is less well defined [5]. Their unique needs may be unknown to the nonhematologists (primary care or emergency room physician) who participate in their care [6].


Using data from the Sickle Cell Data Collection Program [7] and Registry and Education for Hemovigilance in Hemoglobinopathy Transfusion Therapy (REdHHoTT), we attempt to better characterize the size of suspected NTDT and risk for transfusionassociated complications by focusing on those receiving intermittent transfusions in Georgia from 2007-2016. Our protocol for surveillance data collection was IRB exempt through Georgia State University; participant consent was not required.

Thalassemia case definition included individuals who had ≥3 healthcare encounters with a thalassemia diagnosis code (ICD9/10 codes) using hospital discharge data (inpatient and emergency department). Transfusions were identified by ICD9/10, CPT, revenue, or HCPCS code for red cell exchange or transfusion.


Of 428 thalassemia patients identified, 187 (43.7%) had ≥1 transfusion. Sixty-nine (36.9%) of those patients received 1 transfusion; 118 had multiple transfusions. Of those multiply transfused, 57 patients (48.3%) received transfusions in multiple settings (30% of all transfused patients (Figure 1)). Of the 187 patients receiving ≥1 transfusion, women were transfused on average 50% more independent of the frequency of transfusion. Pediatric patients (0-19 years old) received the lowest number of transfusions (Figure 2).

Citation: Rollins MR, Boudreaux J, Eckman J, Branscomb J, Zhou M and Snyder A. Intermittent Transfusions for Treatment of Thalassemia in the State of Georgia, 2007-2016. Ann Hematol Oncol. 2021; 8(4): 1340.