Abstract
Venous thromboembolism is often underestimated in transfusion-dependent thalassemia
(TDT) patients, as arterial thrombotic events are more commonly observed. Although
therapeutic advancements have transformed this disease from a once-fatal childhood
disease into a manageable chronic condition, some treatments may contribute to an
increased risk of thrombosis. Additionally, the prolonged life expectancy of these
patients further contributes to the overall thrombotic risk. Patients with thalassemia
major present multiple challenges when considering anticoagulation therapy. The decision-making
process is complicated by a delicate balance between thrombotic risk—driven by disease-related
and treatment-associated factors—and potential bleeding tendencies, particularly in
the presence of comorbid conditions such as liver dysfunction, hypersplenism, or thrombocytopenia.
Therefore, ongoing assessment of both thrombotic and bleeding risk and the implementation
of appropriate preventive strategies are essential to optimize patient outcomes. This
document presents a consensus statement from the Steering Committee of the Hemostasis
Working Group of the Hellenic Society of Hematology, offering guidance on thromboprophylaxis
and anticoagulation management in adult TDT patients.
Keywords transfusion-dependent thalassemia - thalassemia major - venous thromboembolism - thromboprophylaxis
- anticoagulation
