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Iron Chelation in Thalassaemia — RACP Paediatrics MCQ

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ModerateHaematology & OncologyIron Chelation in ThalassaemiaRACP Paediatrics

A 2-year-old with beta-thalassaemia major is on a regular transfusion program. His ferritin is 2500 mcg/L. What complication is being prevented by iron chelation therapy?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Iron overload causing cardiac and hepatic damage

Transfusional iron overload causes cardiac siderosis (leading cause of death), hepatic fibrosis/cirrhosis, endocrine dysfunction (diabetes, hypogonadism, growth failure), and skin hyperpigmentation. Iron chelation (deferasirox oral, desferrioxamine SC/IV, or deferiprone oral) is commenced when ferritin exceeds 1000 mcg/L or after 10-20 transfusions.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Thalassaemia Major