There are several ways of classifying thalassemia, with one of the simplest based on the need to transfuse. Clinically this is helpful since there is such a wide spectrum of mutations and combinations that may be involved. The author is from the University of Oxford.
Main types of NTD thalassemia:
(1) beta-thalassemia intermedia
(2) hemoglobin E beta-thalassemia
(3) hemoglobin H disease
Other type of NTD thalassemia:
(4) hemoglobin S beta-thalassemia
(5) hemoglobin C thalassemia
Exclusions: hemoglobin S beta-0 thalassemia
Clinical features:
(1) limited or no requirements for regular blood transfusion
(2) need for transfusion under certain circumstances (pregnancy, infection, surgery)
(3) normal growth even in the face of low hemoglobin concentrations
A child should not be designated transfusion-dependent if there is a need to transfuse during an infection or procedure. The assessment should be performed when the child has recovered and returned to baseline.
A patient with NTD thalassemia may have complications (splenomegaly, iron overload, etc) later in life and may show an increased need for blood transfusions.
