Transfusion-Dependent Thalassemia and Venous Thromboembolism Management: Position Statement from the Steering Committees of Hemostasis and Erythrocyte and Hemoglobinopathies Study Groups—Hellenic Society of Haematology

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

Publication History

Received: 05 June 2025

Accepted: 28 July 2025

Accepted Manuscript online:
29 July 2025

Article published online:
22 August 2025

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