en Pediatric Hematology & Oncology Pediatric Hematology & Oncology پژوهشي Original Article <div style="text-align: justify;"><span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Arial;"><span style="color:black"><b>ntroduction:</b> <a name="_Hlk149127041">Thalassemia, particularly </a>&alpha; and &beta; types, are characterized by mutations causing varied clinical manifestations such as anemia, skeletal deformities, and iron accumulation. Patients with transfusion-dependent thalassemia (TDTs) often face growth and puberty complications, which are influenced by the disease&rsquo;s type and severity. These disruptions not only result from chronic anemia, iron chelation therapy, and endocrinopathies but also significantly impact the patient&rsquo;s quality of life.</span><br> <span style="color:black"><b>Methods:</b> A comprehensive guideline was formulated through a systematic literature review and stakeholder engagements. The protocol emphasizes diagnosing and managing growth and puberty disorders in TDT patients, integrating consistent monitoring, documentation, and patient-specific assessments.</span><br> <span style="color:black"><b>Results:</b> The guideline proposes a detailed monitoring schedule from birth to adulthood, focusing on growth velocity norms and referral criteria to pediatric endocrinologists. It outlines protocols for hormone treatments in cases of delayed or arrested puberty, with distinctions for boys and girls. The treatment approach is multidisciplinary, combining growth monitoring, hormone therapy, and potential surgical interventions. The complexities demand continuous management, with treatment plans tailored to individual patient needs.</span><br> <span style="color:black"><b>Conclusions:</b> The research provides a pivotal national protocol for addressing growth and puberty anomalies in TDT patients, aiming to enhance their well-being and standardize care. The emphasis on proactive, individualized strategies will bolster healthcare outcomes and reduce associated costs.</span></span></span></span></div> <div> <table align="left" hspace="0" vspace="0"> <tbody> <tr> <td style="padding: 0in 12px; text-align: justify;" valign="top"></td> </tr> </tbody> </table> </div> <div style="text-align: justify;"></div> Guideline, Growth, puberty, Transfusion Dependent Thalassemia, Iron Chelators 43 52 http://ijbc.ir/browse.php?a_code=A-10-41-7&slc_lang=en&sid=1 Fariba Ghassemi fariba.ghasemi@yahoo.com 100319475328460010439 100319475328460010439 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Mohammad E. Khamseh m.e.khamseh@gmail.com 100319475328460010440 100319475328460010440 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran Negin Sadighnia negin_sadighnia@yahoo.com 100319475328460010441 100319475328460010441 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Mojtaba Malek malekmoj@yahoo.com 100319475328460010442 100319475328460010442 No Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran Nahid Hashemi-madani nahid.hashemimadani@gmail.com 100319475328460010443 100319475328460010443 No Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran Neda Rahimian rahimian.n@iums.ac.ir 100319475328460010444 100319475328460010444 No 2 Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran Pooya Faranoush pooya1375@yahoo.com 100319475328460010445 100319475328460010445 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Ali Elahinia elahinia.ali75@gmail.com 100319475328460010446 100319475328460010446 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Vahid Saeedi vsaeediss@gmail.com 100319475328460010447 100319475328460010447 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Dorsa Fallah Azad dorsafallah99@gmail.com 100319475328460010448 100319475328460010448 No Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran Mohammad Faranoush faranoush47@gmail.com 100319475328460010449 100319475328460010449 Yes Pediatric Growth and Development Research Center, Institute of Endocrinology Iran University of Medical Sciences Tehran Iran