Prof. Dr. Castello: "The high rate of carriage increases the incidence of the disease. The prevalence of beta thalassemia trait in Turkey is 2.1 percent. This rate is increasing in different regions, up to 13 percent.''
Yeditepe University Koşuyolu Hospital Pediatric Bone Marrow Transplantation Clinic Specialist stated that the high rate of the carrier in thalassemia increases the rate of emergence of the disease and added: "In addition to the high rate of the carrier in our country, the high rate of consanguineous marriages also increases the risk of birth of sick children. The prevalence of beta thalassemia trait in Turkey is 2.1 percent. This rate is increasing in different regions, up to 13 percent.''
Our expert reported that beta thalassemia, a blood disease that is inherited from parents to children and also known as Mediterranean anemia, is caused by a genetic disorder in the making of hemoglobin, which is found in the red spheres in the blood and carries oxygen to the tissues. The expert stated that there are approximately 1 million 400 thousand carriers and 4 thousand 500 thalassemia patients in Turkey. The incidence of thalassemia, which is an important public health problem in the Mediterranean Region, including Turkey, has increased with migration in some European countries.
Emphasizing that the number of thalassemias is as important as the number of patients at this point, our expert noted:
"The high rate of carriage increases the incidence of the disease. In addition to the high rate of carriage in our country, the high rate of consanguineous marriages also increases the risk of having a sick child. The prevalence of beta thalassemia trait in Turkey is 2.1 percent. This rate is increasing in different regions, up to 13 percent.'' Especially in the Mediterranean, Aegean, and Thrace regions, the rate is high. Red blood cells have a short life span as a result of a genetic disorder in thalassemia patients and the prominent finding in the disease is deep anemia.
The disease is usually noticed between 3 months and 1 year of age from birth. Mothers and fathers apply to the doctor by noticing pallor in the child, slight jaundice in the eyes, loss of appetite, weakness, and restlessness. However, it can be unnoticed. Deep anemia does not develop in carriers. The blood picture is similar to iron deficiency anemia except for the high rate of red blood cells. Considering the geography of our country, it is important to evaluate patients with iron deficiency anemia in terms of the thalassemia trait. Iron deficiency may also develop in thalassemia carriers, in which case iron deficiency treatment should be given. "
Our expert states: "Thalassemia carriage is not a disease and does not require treatment. A person with a thalassemia carrier lives a healthy life.
But it is important to know that the person is a carrier. Because as a result of the marriage of two carriers, there is a 25 percent chance that each child will be born sick. The children of couples who are not carriers are born healthy. There is no possibility of a sick child being born; while there is a possibility of a carrier child being born."
Emphasizing that hematopoietic stem cell transplantation has been performed all over the world since the 1980s for the definitive treatment of the disease, our expert continued as follows:
"We transplant blood stem cells from bone marrow to thalassemia patients, especially from siblings with matching tissue groups or relatives and unrelated donors with matching tissue groups. With the transplant process, we destroy the diseased cells in the patient's bone marrow and replace them with the stem cells of the donor, which make healthy red blood cells. With hematopoietic stem cell transplantation, the patient's genetics do not change, but the problem in the bone marrow that reveals the disease picture and where the life-threatening problem lies are solved. As a result, the donor's stem cells produce red blood cells that carry healthy hemoglobin, and the patient no longer needs blood support and lives a healthy life.”
Our expert, who also gives information about who can benefit from stem cell transplantation among thalassemia patients, also added the following about the subject: "We are afraid to do this in advanced thalassemia patients with very serious organ damage. Despite regular and appropriate blood transfusion and iron chelation therapy, organs are affected over the years, so it is necessary to evaluate the patient very well before stem cell transplantation. It is important to be able to perform stem cell transplantation as early as possible. If the patient has a sibling whose tissue type matches, the success is very high when it is applied without waiting. Stem cell transplantation is also performed in patients with advanced age and well followed up and treated thalassemia.''
Our specialist stated that thousands of thalassemia patients around the world are treated with stem cell transplantation and that it is taking time to do so, and that surrogate sibling can become donors.
"The siblings of the vast majority of our patients with thalassemia, whom we have transplanted stem cells, are also carriers. Therefore, we turn patient thalassemia, which we call thalassemia major, into a healthy thalassemia carrier after stem cell transplantation. Since the carriage is not a disease, it is possible to live a healthy life. In cases where the transplant fails, the patient returns to the thalassemia state. Some patients can be transplanted for the second time.''
As in the treatment of many diseases, our expert pointed out that extremely successful results have been obtained in Turkey regarding bone marrow transplantation in thalassemia and emphasized the importance of treating thalassemia as a public health problem.
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Alo Yeditepe