What are the current guidelines for the management of iron overload in patients with beta thalassaemia?

For patients with beta thalassaemia, particularly in the context of pregnancy, iron chelation therapy may be required to control iron overload [RCOG, 2014]. Referral for assessment and monitoring well in advance of pregnancy is important to allow for this therapy [RCOG, 2014].

Iron overload in beta thalassaemia can lead to significant complications, including maternal cardiomyopathy and hypogonadotrophic hypogonadism, which can affect fertility [Naik and Lanzkron, 2012; RCOG, 2014]. A multidisciplinary team, including a specialist obstetrician and haematologist, should provide pre-conception counselling to discuss the impact of thalassaemia on pregnancy and plan management [RCOG, 2014].

While specific guidelines for general iron overload management in beta thalassaemia were not extensively detailed in the provided context, general principles for preventing iron overload include routine monitoring of iron stores using serum ferritin at intervals of 1 to 3 months ⁴. Serum ferritin levels in adults, children, and young people treated with iron should not rise above 800 micrograms/litre, and the iron dose should be reviewed when levels reach 500 micrograms/litre to prevent this ⁴.