Sep 24, 1996
Sampras battles inherited anemia
By Tom Tebbutt
For the supremely talented Pete Sampras, it is unlikely that any opponent will prove as much of a challenge as thalassemia.
A Sept. 10 story in The Toronto Globe and Mail speculated that the world No. 1 suffered from some form of anemia, and it has been learned that Sampras has an inherited condition that is almost certainly thalassemia minor, a congenital form of anemia common among people from the Mediterranean.
Sampras's mother, Georgia, was born in Greece, and his father, Sam, is of Greek ancestry. Having thalassemia minor means the 25-year-old Sampras has a low count of hemoglobin, which carries oxygen in red blood cells.
"It's a mild to moderate anemia and you lead a normal life with no reduction in life expectancy," Toronto hematologist Dr. George Kutas explained. "A weekend hacker probably wouldn't even notice it."
Thalassemia minor is inherited from one parent. The much more serious thalassemia major results if both parents pass on the defective gene.
"Sampras would be very sick and not playing tennis if he had thalassemia major," Kutas said emphatically.
The more serious form is characterized by the need for continuing blood transfusions, stunted growth and the many possible complications arising from multiple transfusions.
"Thalassemia minor is a lifelong thing that people adjust to," Kutas said. "The prognosis for Sampras over the next few years is not much different than it has been, because thalassemia is set at birth and it doesn't get worse or better."
"There haven't been many world-class athletes with thalassemia, so there's no literature available on the subject. We don't have studies to prove it, but due to the limited oxygen-carrying capacity, an athlete might get to the point where he could no longer increase his cardiovascular output because of a limited number of red blood cells. That would impair the extra effort required at that top level of sport."
Inhaling oxygen, as is done in some sports, notably football, would not be a solution for Sampras.
"That probably wouldn't help," Kutas said, "because there's nothing wrong with the red blood cells carrying the oxygen, it's just that there's not enough hemoglobin."
What could Sampras do during a match?
"Other than getting a transfusion before the tournament, there's not much you can do," Kutas said.
The effects of a transfusion (but not with his own blood, because it's already low in hemoglobin) would easily last the two weeks of a tournament like the U.S. Open (which Sampras won two weeks ago). But it's unlikely he would have one because of all the possible negative side effects.
A blood transfusion would not be considered to be blood doping, a dangerous practice used by some world-class athletes.
"Blood doping is when you have normal hemoglobin levels and you want exceptional hemoglobin levels," Kutas explained. "In Sampras's case, if he did it, it would just be to get his hemoglobin to normal levels."
What advice would Kutas have for Sampras?
"It's obvious that in a long match he gets into more trouble," he said. "One minute he's hunched over leaning on his racquet (as against Alex Corretja in a memorable match at the U.S. Open) and then the next he's serving an ace at 110 miles an hour. I'd basically tell him only to push himself up to a certain point."
Should Sampras be watching what he eats?
"There's nothing he can really do in terms of diet," Kutas said, "because it's a condition you have from birth -- actually it's often mis-diagnosed as a lack of iron."
In Sampras's case, if his mother had the gene, she would likely have learned of her condition during tests when she was pregnant with one of her three children.
"A doctor doing blood tests can pick it up easily," Kutas said. "If hemoglobin levels are lower than normal, they'd just follow up with a simple test to prove it."
Sampras would have a 50-percent chance of passing on the condition if he had children. However, if the child's mother also carried the gene, there's a 25-percent chance that their offspring would have thalassemia major.
As for the effects on Sampras's career, it's clear that he will continue to have problems when he gets involved in long, exhausting matches. But especially at tournaments such as Wimbledon where the points are over quickly, he should be able to perform well and possibly add to his impressive total of eight Grand Slam wins.
If Sampras admits to having thalassemia minor, it would help silence critics who have interpreted his frequent physical breakdowns as being the result of poor preparation and conditioning.