English abstract
The thalassaemias are a group of genetic disorders of haemoglobin which are en demic in the tropics but are now found worldwide due to migration. Basic stand ard of care therapy includes regular transfusions to maintain a haemoglobin level
of around 10 g/dL, together with iron chelation therapy to prevent iron overload.
Novel therapies, bone marrow transplantation, and gene therapy are treatment op tions that are unavailable in many countries with stressed economies. This Wider
Perspectives article presents the strategies for management of an adolescent refugee
patient with beta thalassaemia, as it would be performed by expert haematologists in
six countries: Italy, Lebanon, Oman, the Sudan, Thailand and the United States. The
experienced clinicians in each country have adapted their practice according to the
resources available, which vary greatly. Even in the current modern era, providing
adequate transfusions and chelation is problematic in many countries. On the other
hand, ensuring adherence to therapy, particularly during adolescence, is a similar
challenge seen in all countries. The concluding section highlights the disparities in
available therapies and puts the role of novel therapies into a societal context
