Long-term administration of high-dose deferoxamine 2 days per week in thalassemic patients.
OBJECTIVE
Compliance with parenteral administration of deferoxamine is often poor in thalassemic patients with iron overload. We tested the efficacy and tolerance of the drug at high dosage 2 d per week for 24 months in two adult thalassemic patients with permanently high serum ferritin using a portable pump and an implanted chamber.


METHODS
Deferoxamine was administered using a pressure-operated portable pump through an implanted chamber. The patients were infused over 48 h every week with 198 mg/kg/d (patient 1) and 170 mg/kg/d (patient 2). Serum ferritin levels were measured at regular intervals.


RESULTS
Serum ferritin decreased progressively from 2967 to 457 microg/L in patient 1 and from 6476 to 1951 microg/L in patient 2. Compliance and tolerance to treatment were excellent in the two patients.


CONCLUSIONS
Intravenous administration of high-dose deferoxamine over 48 h per week using a portable pump and implanted chamber improved compliance in two thalassemic adult patients, resulting in a significant decrease in iron overload. We suggest that high-dose chelation therapy should be assessed in selected groups of iron-overload thalassemic patients receiving regular blood transfusions.
Hagège
I
I
Hôpital de Jour de Médecine, Pharmacie, and Laboratore d' Hématologie, Hôpital Tenon, Paris, France.
Becker
A
A
Kerdaffrec
T
T
Kanfer
A
A
Girot
R
R
D000328:Adult; D002614:Chelating Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015913:Chelation Therapy / Q000379:methods; D003676:Deferoxamine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000032:analysis; D006801:Humans; D007260:Infusion Pumps; D007501:Iron; D019190:Iron Overload / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D013789:Thalassemia / Q000628:therapy*; D065227:Transfusion Reaction; D016896:Treatment Outcome
D002614:Chelating Agents; D005293:Ferritins; D007501:Iron; D003676:Deferoxamine