Deferiprone-associated myelotoxicity.
Agranulocytosis developed in a 63-year-old patient with myelodysplasia 6 weeks after commencing treatment with the oral iron chelator deferiprone (L1, 1,2-dimethyl-3-hydroxypyrid-4-one, CP20) at a daily dose of 79 mg/kg. This was the 3rd case of agranulocytosis (neutrophils 0 x 10(9)/l) in clinical trials of L1 at the Royal Free Hospital. The neutrophil count recovered 7 days after stopping L1 and commencing G-CSF at a dose of 300 micrograms daily. Three other patients with milder degrees of neutropenia (neutrophils < 1.5 x 10(9)/l) have also been observed in our trials. The case histories of these 4 patients are described here; other reported cases of neutropenia or agranulocytosis are reviewed. Based on worldwide long-term clinical trials the incidence of agranulocytosis is about 1.6% and of neutropenia 2%.
al-Refaie
F N
FN
Department of Haematology, Royal Free Hospital, School of Medicine, London, UK.
Wonke
B
B
Hoffbrand
A V
AV
D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced*; D000077543:Deferiprone; D005260:Female; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D011728:Pyridones / Q000009:adverse effects*; D013789:Thalassemia / Q000188:drug therapy
D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone