Contributions
Abstract: PB2195
Type: Publication Only
Background
Frequent transfusions required for β- thalassemia major patients cause iron overload. Without the appropriate chelation therapy, iron toxicity can cause significant heart, liver and endocrine morbidity.
Aims
In this case series we estimated the safety and efficacy of iron chelation with the combination of deferasirox (DFX) and deferoxamine (DFO) in transfusion dependent thalassemia (TDT) patients attending the Thalassemia Unit in a tertiary hospital in Athens, Greece.
Methods
10 TDT patients were treated with a combination chelation therapy of DFX (30 ±10mg/kg/d) and DFO (44 ± 12mg/kg/d for 2-6 days/wk in 12hr or 24hr infusion rates). Reasons for starting this combination treatment included: 1) treatment with one chelating agent did not succeed in decreasing heart and liver iron, 2) agranulocytosis or severe neutropenia due to deferiprone (DFP) treatment and 3) adverse events recorded with increased doses of one of the chelating agents.
Results
Five of the 10 patients had significant liver hemosiderosis (LIC >15 mg Fe/gr d.w.) and 3 had heart iron overload, of which one significant (T2* 1.9msec).
Before starting DFX/DFO combination therapy | 12mos into the DFX/DFO combination therapy | |
Serum Ferritin mean | 3,360 ng/mL (range 1,700- 6,200) | 2,450 ng/mL (range 800-4,900) |
Liver Iron Concentration (LIC) mean | 19.0 mg Fe/gr d.w. (range 6.2-46.4) | 9 mg Fe/gr d.w. (range 1.6- 28.4) |
Cardiac T2* mean | 24.1 msec (range 1.9-36) | 32.3 msec (range 5.2 -39.5) |
Conclusion
The combination chelation with DFX/DFO can decrease iron overload and represents a safe and effective option when monotherapy is not effective or not well tolerated.
Session topic: 26. Thalassemias
Keyword(s): Thalassemia, Liver iron concentration, Chelation
Abstract: PB2195
Type: Publication Only
Background
Frequent transfusions required for β- thalassemia major patients cause iron overload. Without the appropriate chelation therapy, iron toxicity can cause significant heart, liver and endocrine morbidity.
Aims
In this case series we estimated the safety and efficacy of iron chelation with the combination of deferasirox (DFX) and deferoxamine (DFO) in transfusion dependent thalassemia (TDT) patients attending the Thalassemia Unit in a tertiary hospital in Athens, Greece.
Methods
10 TDT patients were treated with a combination chelation therapy of DFX (30 ±10mg/kg/d) and DFO (44 ± 12mg/kg/d for 2-6 days/wk in 12hr or 24hr infusion rates). Reasons for starting this combination treatment included: 1) treatment with one chelating agent did not succeed in decreasing heart and liver iron, 2) agranulocytosis or severe neutropenia due to deferiprone (DFP) treatment and 3) adverse events recorded with increased doses of one of the chelating agents.
Results
Five of the 10 patients had significant liver hemosiderosis (LIC >15 mg Fe/gr d.w.) and 3 had heart iron overload, of which one significant (T2* 1.9msec).
Before starting DFX/DFO combination therapy | 12mos into the DFX/DFO combination therapy | |
Serum Ferritin mean | 3,360 ng/mL (range 1,700- 6,200) | 2,450 ng/mL (range 800-4,900) |
Liver Iron Concentration (LIC) mean | 19.0 mg Fe/gr d.w. (range 6.2-46.4) | 9 mg Fe/gr d.w. (range 1.6- 28.4) |
Cardiac T2* mean | 24.1 msec (range 1.9-36) | 32.3 msec (range 5.2 -39.5) |
Conclusion
The combination chelation with DFX/DFO can decrease iron overload and represents a safe and effective option when monotherapy is not effective or not well tolerated.
Session topic: 26. Thalassemias
Keyword(s): Thalassemia, Liver iron concentration, Chelation