The purpose of this study is to continue to learn about impact of comprehensive care on the natural history of patients with thalassemia (Cooley’s anemia) and other severe anemias requiring periodic or regular red blood cell transfusions. We will collect data on guideline recommended measures obtained from the standard of care: routine tests (EKG, Echocardiogram, Holter Monitor, MRI, eye exam, hearing test, x-ray, bone studies, pulmonary function study) done once a year and monthly blood draw and urinalysis for complete blood count, chemistries, and iron studies.