Decline in height percentile observed in a child with thalassemia major. The patient began therapy at age 4 years, 11 months (arrow) with nightly subcutaneous deferoxamine (initial dose, 11 mg deferoxamine per kilogram per day; mean dose over the first 3 years of therapy, 55 ± 17 mg/kg/d). This patient had normal radiographs before the start of deferoxamine (see Fig 8A) but subsequently developed marked growth failure with a dramatic decline in height percentile, from the 37th percentile for age 6 months before initiation of deferoxamine, to less than the 3rd percentile 36 months later. (Reprinted with permission.144 )