of 8–16 hours, the deferasirox pill can be taken just once each day. a once-daily dose of 20 mg/kg of body weight has been found to be sufficient for most patients for the maintenance of liver iron concentration (lic) levels, which are usually measured as mg of iron per g of liver tissue. larger doses may be required for some patients in order to reduce lic levels. the ability of deferasirox to effectively reduce lic levels has been well documented. one study demonstrated that after 4–5 years of deferasirox treatment the mean lic levels of patients decreased from 17.4 ± 10.5 to 9.6 ± 8.0 mg fe/g. this study showed that long-term treatment did result in a sustainable reduction in the iron burden faced by patients receiving blood transfusions for thalassemia. an additional benefit of the use of deferasirox instead of desferoxamine is that, unlike desferoxamine, early studies have indicated that deferasirox does not have a significant impact on the growth and development of pediatric thalassemia patients. in a study by cappellini et al. it was shown that children receiving the treatment displayed continual near-normal growth and development over a 5-year study period. side effects deferasirox can, however, have a wide variety of side effects. these may include headaches, nausea, vomiting, and joint pains. some evidence has been shown of a link to gastrointestinal disorders experienced by some people who have received the treatment. structure indicaxanthin, the yellow pigment of the cactus pear fruit indicaxanthin is a pigment derived from the cactus pear fruit and can be used as an antioxidant. dietary indicaxanthin has been shown to have protective effects on rbcs in people with beta thalassemia. it has a structure similar to that of amino acids, and is amphiphilic: it is able to bind to cell membranes through charge-related interactions with polar head groups of membrane constituents, as well through adsorption to the lipid aggregates. upon ex vivo introduction to thalassemic blood, indicaxanthin was shown to accumulate within rbcs. function hb undergoes the following oxidation reaction during normal controlled breakdown of rbcs: hb → oxy-hb → met-hb → → oxoferryl → further oxidation steps this reaction is experienced by thalassemic rbcs to a greater extent because, not only are there more oxidative radicals in thalassemic blood, but thalassemic rbcs also have limited antioxidant defense. indicaxanthin is able to reduce the perferryl-hb, a reactive intermediate, back to met-hb. the overall effect of this step is that hb degradation is prevented, which helps prevent accelerated breakdown of rbcs. in addition, indicaxathin has been shown to reduce oxidative damage in cells and tissues and does so by binding to radicals. the mechanism of its function, however, is still unknown. indicaxanthin has high bioavailability and minimal side effects, like vomiting or diarrhea. carrier detection a screening policy exists in cyprus to reduce the incidence of thalassemia, which since the program's implementation in the 1970s (which also includes pre-natal screening and abortion) has reduced the number of children born with the hereditary blood disease from 1 out of every 158 births to almost zero. in iran as a premarital screening, the man's red cell indices are checked first, if he has microcytosis (mean cell hemoglobin < 27 pg or mean red cell volume < 80 fl), the woman is tested. when both are microcytic their hemoglobin a2 concentrations are measured. if both have a concentration above 3.5% (diagnostic of thalassemia trait) they are referred to the local designated health post for genetic counseling. in 2008, in spain, a baby was selectively implanted in order to be a cure for his brother's thalassemia. the child was born from an embryo screened to be free of the disease before implantation with in vitro fertilization. the baby's supply of immunologically compatible cord blood was saved for transplantation to his brother. the transplantation was considered successful. in 2009, a group of doctors and specialists in chennai and coimbatore registered the successful treatment of thalassemia in a child using a sibling's umbilical cord blood. bone marrow transplant it is possible to be cured, by a bone marrow transplantation (bmt) from compatible donor. in low-risk young people, the thalassemia-free survival rate is 87%; the mortality risk is 3%. the drawback is that this method requires an hla-matched compatible donor. if the person does not have an hla-matched compatible donor, there is another method called bone marrow transplantation from haploidentical mother to child (mismatched donor), in which the donor is the mother. the results are these: thalassemia-free survival rate 70%, rejection 23%, and mortality 7%. the best results are with very young people.