{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:25:47Z","timestamp":1791973547833,"version":"4.4.0"},"reference-count":99,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2002,1,1]]},"abstract":"<jats:p>Thalassemia is a congenital hemolytic disorder caused by a partial or complete deficiency of \u03b1- or \u03b2-globin chain synthesis. Homozygous carriers of \u03b2-globin gene defects suffer from severe anemia and other serious complications from early childhood. The disease is treated by chronic blood transfusion. However, this can cause severe iron overload resulting in progressive organ failure. Some forms of \u03b1 thalassemia are also associated with a similar clinical picture. Despite the difficulties associated with treatment, standards of care for thalassemic patients have improved in recent years, resulting in almost doubling of the average life expectancy. As a consequence, additional previously undescribed, complications are now being recognized. In particular, profound hemostatic changes have been observed in patients with \u03b2-thalassemia major (\u03b2-TM) and \u03b2-thalassemia intermedia (\u03b2-TI) and also in patients with \u03b1 thalassemia (hemoglobin H disease). The presence of a higher than normal incidence of thromboembolic events, mainly in \u03b2-TI, and the existence of prothrombotic hemostatic anomalies in the majority of the patients, even from a very young age, have led to the recognition of the existence of a chronic hypercoagulable state in thalassemic patients. Despite the appearance of numerous publications on the frequent occurrence of thromboembolic complications in thalassemia, this complication has not been emphasized or comprehensively reviewed. This review summarizes the current literature and discusses possible mechanisms of the lifelong hypercoagulable state that exists in thalassemia.<\/jats:p>","DOI":"10.1182\/blood.v99.1.36","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T12:46:40Z","timestamp":1027774000000},"page":"36-43","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":378,"title":["The hypercoagulable state in thalassemia"],"prefix":"10.1182","volume":"99","author":[{"given":"Amiram","family":"Eldor","sequence":"first","affiliation":[{"name":"From the Institute of Hematology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; and Department of Hematology, Edith Wolfson Medical Center, Holon, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliezer A.","family":"Rachmilewitz","sequence":"additional","affiliation":[{"name":"From the Institute of Hematology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; and Department of Hematology, Edith Wolfson Medical Center, Holon, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"key":"2020021218405510400_B1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/j.1749-6632.1998.tb10479.x","article-title":"Survival and disease complications in thalassemia major.","volume":"850","author":"Borgna-Pignatti","year":"1998","journal-title":"Ann N Y Acad Sci."},{"key":"2020021218405510400_B2","first-page":"915","article-title":"Thrombotic risk in thalassemic patients.","volume":"11","author":"Moratelli","year":"1998","journal-title":"J Pediatr Endocrinol Metab."},{"key":"2020021218405510400_B3","first-page":"92","article-title":"A chronic hypercoagulable state and life-long platelet activation in beta thalassemia major.","volume":"24","author":"Eldor","year":"1993","journal-title":"Southeast Asian J Trop Med Public Health."},{"key":"2020021218405510400_B4","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1046\/j.1365-2141.1999.01758.x","article-title":"A chronic hypercoagulable state in patients with beta-thalassemia major is already present in childhood.","volume":"107","author":"Eldor","year":"1999","journal-title":"Br J Haematol."},{"key":"2020021218405510400_B5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1056\/NEJM199907083410207","article-title":"The \u03b2-thalassemias.","volume":"341","author":"Olivieri","year":"1999","journal-title":"N Engl J Med."},{"key":"2020021218405510400_B6","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1212\/WNL.22.3.294","article-title":"Thalassemia major (homozygous beta-thalassemia). 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