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Thread: Thalassemia and your TG

  1. #1
    Foundation Member Thai Dreamer ผู้เพ้อฝัน G4orce's Avatar
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    Thalassemia and your TG

    As most would know my Thai wife is pregnant with our first baby. We just recently found out that Mrs G has a mild case of Thalassemia. When the doctor told us that I had no idea what was going on but Mrs G knew exactly what it was.

    Thalassemia, the disorder is caused by the weakening and destruction of red blood cells. Thalassemia is caused by variant or missing genes that affect how the body makes hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen. People with thalassemia make less hemoglobin and have fewer circulating red blood cells than normal, which results in mild or severe anemia. Thalassemia will be present as microcytic anemia. This is often found is SE Asian countries or Mediterranean regions of Europe.

    We are very thankful that Mrs G only has a mild case of this and I was also required to be tested for it and found out I am clear of it. If we were to both have it we could have passed on a Major case to our unborn baby which would casue many problems. Thankfully the worst case scenario now is that our baby MAY have a mild case of Thalassemia and when he or she decides to have children with his/her partner, they will both have to be tested for it before planning children.

    The point of this thread is that if you and your TG are planning to have children get tested for this. I believe if you know before falling pregnant there are precausions/treatments that can be taken to help your future child.

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    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน Moo Uaon's Avatar
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    Ah,yes rings a bell.

    That came up when my GF was pregnant.

    Something to do with her blood being abnormal and therefore resistant to some nasty diseases being transmitted by mosquitoes,by memory.

    Generations before her who didn't have it would have died out from Malaria and the like,was the way i think the story went.

    So it seems it's quite common amongst the Isaan folk.
    FACE YOUR FEARS LIVE YOUR DREAMS

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    Uber Star Soi wanderer Uber Dreamer ผู้เพ้อฝัน
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    Yes, protects against Malaria, get taught this in Biochemistry. An interesting article I saw today;

    BBC News - Tibetan altitude gene inherited 'from extinct species'

    G4orce, you married a mutant! 555

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    Foundation Member Thai Dreamer ผู้เพ้อฝัน G4orce's Avatar
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    Quote Originally Posted by Bawdy View Post
    G4orce, you married a mutant! 555
    A knew there was something...... Different....... about her 5555

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    Uber Star Soi wanderer Uber Dreamer ผู้เพ้อฝัน
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    ^ 555 I meant 'mutant' in a good way btw, many of us are, myself included (eg. lactose intolerant people are the originals, we that can digest lactose as adults are the mutants, human milk has more lactose than cows milk btw).
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    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน RakThai's Avatar
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    Quote Originally Posted by G4orce View Post
    As most would know my Thai wife is pregnant with our first baby. We just recently found out that Mrs G has a mild case of Thalassemia. When the doctor told us that I had no idea what was going on but Mrs G knew exactly what it was.

    Thalassemia, the disorder is caused by the weakening and destruction of red blood cells. Thalassemia is caused by variant or missing genes that affect how the body makes hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen. People with thalassemia make less hemoglobin and have fewer circulating red blood cells than normal, which results in mild or severe anemia. Thalassemia will be present as microcytic anemia. This is often found is SE Asian countries or Mediterranean regions of Europe.

    We are very thankful that Mrs G only has a mild case of this and I was also required to be tested for it and found out I am clear of it. If we were to both have it we could have passed on a Major case to our unborn baby which would casue many problems. Thankfully the worst case scenario now is that our baby MAY have a mild case of Thalassemia and when he or she decides to have children with his/her partner, they will both have to be tested for it before planning children.

    The point of this thread is that if you and your TG are planning to have children get tested for this. I believe if you know before falling pregnant there are precausions/treatments that can be taken to help your future child.
    Hmm.. Feel like I have to respond here, because maybe you are worrying over nothing (well…very little). Difficult stuff to explain though, but I will try in a simplified version..

    Thalassemia is an autosomal recessive disorder (not always, but in the large majority).

    To explain what this means a short lesson in very basic genetics.. All genetic traits are determined by gene pairs, one gene coming from maternal side, and one gene from paternal side.
    Depending on the trait, these genes can be dominant, recessive or intermediate…
    For example, if the gene A in a flower determines the color, A being red and a being white..
    The combination AA will be red, Aa will be red, and only aa will be white..
    So crossing a red flower with a white flower will only give red flowers if the red flower has 2 A’s, and will give 50% red and 50% white flowers if the red flower has Aa genes.
    Crossing 2 red (Aa) flowers, will give 25% AA red, 50% Aa red, and 25% aa white flowers..
    So the recessive gene only expresses itself when there is no dominant gene present.

    Now to Thalassemia..
    If A is the normal gene for hemoglobin, and a is the gene for Thallasemic hemoglobin, only the aa genotype will have the disease Thalassemia.
    AA is not effected, and the Aa configuration is a carrier without the disease..
    So crossing a normal person (AA) with a Thalassemia carrier (Aa), will give 50% normal and a 50% carrier result. No Thalassemia patients offspring!

    Unfortunately, it’s more complicated than that.. The gene for hemoglobin is known to have a chance for mutations.. And if one gene is defected by mutation (let’s call it A*), and the other gene is a Thalassemic gene (a), then the Thalasemic gene will present itself to a degree.. This is the disease called Thalassemia minor (and called that long before genetic testing was possible).

    Mild Thalassemia is popular used word, but it both used for carriers and for patients of Thalassemia minor. But the two are very different!

    My question to you would be (or advice to ask your wife’s doctor), are we talking about Thalassemia minor? Or about carrying Thalassemia?

    For your child, the risk of real Thalassemia (Thalassemia Major) is zero..
    Risk for being a carrier is 50%
    And risk of Thalassemia minor only exists if you have a mutation on one of the A’s.. (if the small a comes from the mother, the A* can only come from you. Chance very small though).
    Quarky and justcruzing1 like this.

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    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน justcruzing1's Avatar
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    ^^^^ (raising hand) "Please Sir.. can I go to the toilet?" 55555

    One thing about this forum, I learn something everyday...thanks for making it understandable.
    "Of course you love me darling, I handsome man 55555"

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    Foundation Member Thai Dreamer ผู้เพ้อฝัน G4orce's Avatar
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    Quote Originally Posted by RakThai View Post
    For your child, the risk of real Thalassemia (Thalassemia Major) is zero..
    Risk for being a carrier is 50%
    And risk of Thalassemia minor only exists if you have a mutation on one of the A’s.. (if the small a comes from the mother, the A* can only come from you. Chance very small though).
    Thanks RakThai.
    I was initially worried as i had no idea what it was but I went straight home and look it up and not all that worried about it now.What you have said in the Quote above it exactly what the doctor has told us.
    Using your terminology my wife HAS Thalassemia Minor (not just a carrier) and has the gene structure of Aa.

    So i am AA and my wife is Aa, so our childen may become an Aa but cannot become an aa. Hope that makes sense
    Last edited by G4orce; 5th July 2014 at 01:22.

  9. #9
    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน RakThai's Avatar
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    Quote Originally Posted by G4orce View Post
    Thanks JC.
    I was initially worried as i had no idea what it was but I went straight home and look it up and not all that worried about it now.What you have said in the Quote above it exactly what the doctor has told us.
    Using your terminology my wife HAS Thalassemia Minor (not just a carrier) and has the gene structure of Aa.

    So i am AA and my wife is Aa, so our childen may become an Aa but cannot become an aa. Hope that makes sense
    Makes perfect sense to me!

    And JC... I think he's still at the toilet..5555

  10. #10
    Frequent Flyer kaptainrob's Avatar
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    ... just learnt something too
    Ignored this thread initially as I thought G was off to Greek Islands DOH

    Anyone think we need a medical forum with RT as Mod?
    Cheers, Rob.
    Lifes journey is not to arrive at the grave safely in a well-preserved body, but to skid in sideways totally worn out, shouting: holy s.h.i.t what a ride!

  11. #11
    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน RakThai's Avatar
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    Quote Originally Posted by kaptainrob View Post
    ... just learnt something too
    Ignored this thread initially as I thought G was off to Greek Islands DOH

    Anyone think we need a medical forum with RT as Mod?
    As Mod..? What are you thinking? 55555

  12. #12
    Organic AI Quarky's Avatar
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    Only if Rak changes his avatar to Dr Rak.... 55

    Funny... no one ever question's Rak's medical posts... I want a second opinion.... 555
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  13. #13
    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน Moo Uaon's Avatar
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    ^ ask M26?

    No need to ask 555
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    ประเทศไทยเพื่อน Founding Member Thai Dreamer ผู้เพ้อฝัน Changone's Avatar
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    I had never heard of this condition.
    But I have heard of "Sickle cell anaemia" which is similar, apparently?
    And where the hell was Biggles.....?....when you needed him last Saturday....?

  15. #15
    Uber Star Soi wanderer Thai Dreamer ผู้เพ้อฝัน RakThai's Avatar
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    Quote Originally Posted by Changone View Post
    I had never heard of this condition.
    But I have heard of "Sickle cell anaemia" which is similar, apparently?
    It is similar. Both diseases are genetic, change the hemoglobin molecule, protect against malaria and can cause anemia.
    Biggest difference is that Thalassemia is a recessive disorder, while Sickle cell anemia is a (incomplete) dominant disorder, meaning one gene will show symptoms..

  16. #16
    Thai Dreamer ผู้เพ้อฝัน Hatari's Avatar
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    There is an article in Bangkok Post today on this topic

    May be of interest to someone - in full here as BP archive most articles after 6 months when they become subscription only

    Making blood count
    New Life Samitivej's Bone Marrow Transplant Fund is helping Thais with Thalassemia


    Published: 24 Sep 2014

    Tanyanee Chaisom found out her son, Zen, had Thalassemia when he was two years old. He was running a high fever and had a haemoglobin electrophoresis test — a blood screening done to evaluate the different types of haemoglobin in the bloodstream. His Thalassemia treatment started immediately.

    Thalassemia is an inherited blood disorder caused by genetic mutation of haemoglobin. In order for a child to get Thalassemia, both parents must be carriers but they don’t necessarily suffer from it, explained Suradej Hongeng, paediatrician, paediatric-hematologist and oncologist.

    “In the past, people who had the disorder did not live long enough to reproduce,” he adds. “Without a bone-marrow transplant, a patient with supportive treatment lives for 25 to 30 years.”

    For a healthy person, red blood cells have an average lifespan of 120 days. For a person suffering from Thalassemia, the red blood cells function only between two and four weeks. They are very easily damaged due to an abnormality in the goblin chain. The patients then suffer from anaemia.

    Zen is one of 800,000 people suffering from Thalassemia in Thailand, with about 3,000 new cases each year. Forty percent of the Thai population are said to be Thalassemia carriers.

    Zen’s early memories of his life involved monthly blood transfusions to maintain a balanced haemoglobin level and daily iron-chelating Desferal injections to prevent iron overload, a side effect of the blood transfusion. The excess iron is deposited in the organs and can be fatal. The injection must be administered slowly, by infusion under the skin, which can take up to 12 hours a day, 7 days a week.

    “There were no other forms of treatments back then,” says Tanyanee. “The excess iron exits the body through the urine, which appears red. It wasn’t until later than oral medication was available for iron overload.”

    Zen relied on this supportive treatment while he waited for an HLA-matched stem cell donor.

    Advancement in technology has changed the way Thalassemia can be treated over the past few decades, making treatment much more feasible.

    “Previously, for a hematopoietic stem cell transplant [bone marrow transplant], the stem cell had to be from a sibling, who has a 25% chance of matching HLA,” says Dr Suradej. “It was later that the process could be done with cells not just from the bone marrow, but also the placenta or blood vessels, which means that the blood must have the same HLA but doesn’t have to be the same type. This allows for transplant with stem cells from unrelated donors.”

    The donor registry at the Thai Red Cross has 150,000 volunteer donors, increasing the chance of matching by 40%. Dr Suradej is the first doctor to perform the first successful unrelated transplant in Thailand.

    But finding a match wasn’t so easy. “We waited for 5 years. We were trying to find matches in Taiwan and in the United States,” says Tanyanee.

    Tanyanee had two more children, despite the 25% risk of each child having Thalassemia and 25% chance of each being a carrier, with the hopes that they would be a match.

    “We didn’t have much of a choice. If we didn’t find a match, it was counting the years Zen would have. Zen would have had no chance,” she says. In 2007, when he was seven, Zen received a transplant. He is now healthy.

    Since the time of Zen’s transplant, much progress has been made in the treatment of Thalassemia.

    “Now, there’s a new technology which allows for transplants with half-HLA match, where the mother or father can be donors. The process is called HAPLO identical. The success of this is a game changer,” says Dr Suradej. “In Thailand, there have been 13 cases of successful transplants, with the first patient remaining healthy two years after the transplant.”

    The fact that a parent can be a donor eliminates the difficulties and trauma of searching for donors. Zen’s case would be much less complicated today than it was over a decade ago.

    Samitivej Hospital has set up the New Life Samitivej’s Bone Marrow Transplant Fund to ensure that treatment performed by the new technique is getting to as many people as possible by funding the transplant.

    Patients eligible must meet four requirements:
    - Must be Thai.
    - Blood disorder must be Thalassemia.
    - Must be healthy, meaning the body must be ready for the transplant so that there is minimal risk.
    - Family must have a total income of less than 30,000 baht a month.

  17. #17
    ประเทศไทยเพื่อน Founding Member Thai Dreamer ผู้เพ้อฝัน Changone's Avatar
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    A bit of good news on the horizon for the mrs G...?

    Genetic therapy offers hope to people facing fatal diseases - 22/01/2015
    And where the hell was Biggles.....?....when you needed him last Saturday....?

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