PMID: 9190035Feb 1, 1997Paper

Fetal erythropoiesis and the diagnosis and treatment of hemoglobin disorders in the fetus and child

Seminars in Perinatology
N F Olivieri

Abstract

Although synthesis of adult hemoglobin (alpha 2 beta 2) is reduced or absent in both alpha and beta thalassemias, these disorders differ in their clinical significance to the fetus and neonate. alpha-Globin synthesis is observed in the yolk sac by 3 weeks of gestation and, by 9 weeks of gestation, alpha-globin represents the main alpha-like hemoglobin in the fetus. By contrast, the switch to beta-globin chain synthesis usually remains incomplete until 1 year after birth. Therefore, the clinical manifestations of homozygous beta-thalassemia may be ameliorated by sustained synthesis of fetal hemoglobin during the first 6 months of life, whereas up until 10 years ago, homozygous alpha-thalassemia was invariably associated with death in utero. More recently, reports of infants with homozygous alpha-thalassemia surviving the neonatal period have emerged, observations particularly relevant to large numbers of immigrants to North America from Southeast Asia, where alpha-thalassemia is common. Studies of patients with the beta-globin disorders thalassemia and sickle cell disease showed that the severity of both disorders is ameliorated by sustained synthesis of fetal hemoglobin into adult life. Hence, treatment for both these disorders...Continue Reading

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Citations

Dec 13, 2005·Annals of the New York Academy of Sciences·Sylvia T SingerElliott P Vichinsky
Jul 23, 2020·Pediatric Research·Raimund PechlanerUrsula Kiechl-Kohlendorfer
Oct 18, 2005·British Journal of Haematology·Sylvia T SingerUNKNOWN E/beta Thalassaemia Study Group
Sep 30, 2008·American Journal of Hematology·Sylvia T SingerUNKNOWN E/beta Thalassemia Study Group

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