 I'm Dr. Devan Sif, clinical hematologist and bone marrow transplant physician at Manipal Hospital, Dwarka, New Delhi. On account of Thalassemia Day, I would like to talk about something about Thalassemia. Thalassemia is anemia, which basically is an inherited disorder where the gene leading to hemoglobin synthesis are defective. And because of the defect of these genes, the hemoglobin produced in the body is ineffective, leading to something known as ineffective erythroposy. So the problem is that your bone marrow is producing adequate number of red cells, but they are not of the good quality which can sustain in the blood and they get destroyed in your spleen and other parts of the body where blood cells are destroyed, leading to the typical facies of Thalassemia, lonas, chipmunk facies and other symptoms of Thalassemia like anemia. It is very important to understand that Thalassemia is transmitted from parents to children. If both the parents have half Thalassemia, that is Thalassemia minor, then the child becomes complete Thalassemia or Thalassemia major. Thalassymic minors are generally asymptomatic who occasionally on their blood investigation are found to have anemia, mild up to moderate anemia around 7 to 8 grams of anemia, but they do not have any symptoms. But when these two Thalassemic minors, they produce a child who is Thalassemic major, this child is tend to have severe anemia from very early onset that is around 6 to 8 months sometimes even earlier than that requiring regular transfusions. Because of these regular transfusions after some time, these patients they end up iron overload, so that means that iron gets accumulated in their liver, heart and other vital organs leading to quite a number of problems like liver failure, heart failure, diabetes, bone retardation and many other problems. So how we can treat Thalassemia? Before talking about treating Thalassemia, in today's era, in 21st century, I think most important is that we diagnose Thalassemia prenatally so that no child is born with Thalassemia. If parents are North Minors or a community screening should be done so that we can diagnose the Thalassemic minors and prenatal diagnosis of Thalassemia can be done by either Corionic villus sampling or immune synthesis and if the child is having Thalassemia, abortion can be given as an option to parents so that the load of Thalassemia on the world can be decreased. But in case we have a Thalassemic child who is born, very important is that after the diagnosis, the child should be regularly transfused and the blood hemoglobin should be maintained at around more than 9 grand percent so that it does not affect the growth and development of the child. Once the patient has received 10-12 transfusion or the ferritin level which is a marker of iron overload, we can start patient with iron chelation. There are a lot of options of iron chelation available, oral options, subcutaneous option, intravenous option. Depending on the availability of iron overload or like of the patient, we can start patient on these iron chelating agents. After the patient has started on these iron chelating agents, it is necessary a regular follow-up is needed on patient's part that to assess the side effects of these drugs, the level of iron overload in the body because there are a lot of newer techniques which are available now to assess the iron overload like T2 star cardiac MRI, liver MRIs which can help us to assess the iron deposition in these vital organs. The only curative method available now for thalassemia is bone marrow transplantation. There was a time when only math sibling donor transplants were indicated in thalassemia but today we are doing unrelated donor and haploidentical donor transplant as well and which is increasing the rate of children who are able to get this treatment for thalassemia. Most of the patients who get this treatment, they become thalassemic free throughout their life. In the US and UK and France, there are studies which have been conducted for gene therapy where the gene of the thalassemic gene is itself being modified and patient is rendered disease free. So with advent of all these new therapy modalities, we are able to practically achieve cure for thalassemia and on occasion of this thalassemia day, I wish you all a safe, healthy and a thalassemia free world. Thank you.