Clinical care in thalassaemia major has improved dramatically over the last three decades, resulting in an impressive increase in survival rates and quality of life of patients living in countries where such clinical care is both available and affordable.
However, cardiac disease still constitutes one of the most frequent and serious iron-related complications. In fact, currently, it is estimated that cardiac complications, mainly associated with iron overload, are reported to cause 71% of the deaths in patients with thalassaemia major; once heart failure develops, the prognosis is usually poor. On the other hand, the cardiomyopathy may be reversible, if appropriate iron chelation treatment is provided early.
The measurement of the cardiac iron load has an extremely important role to play in the prognosis and monitoring of iron load and also provides a means to assess the effectiveness of the iron chelation treatment protocols. For many years, serum ferritin has been the most commonly used indirect method for body iron estimation. However, the interpretation of ferritin values may be complicated by a variety of conditions, and ferritin levels and liver iron concentration measured by biopsy may lack a consistent relationship.
Now, the use of Magnetic Resonance Imaging (MRI) and more specifically of the T2* sequence is a software used for assessing cardiac iron, non-invasively, has now become the most widely available and validated method for iron overload to date.
TIF, in its continuous quest (and vested interest) for providing the best possible care to patients with thalassaemia wherever, they may live, has undertaken the initiative to promote the installation and use of this technology in major hospitals and/or reference centres in ‘affected’ countries, so that patients with thalassaemia are referred to regularly for assessing the cardiac iron load and for evaluating the effectiveness of their iron chelation therapy protocols.