Combined therapy with deferiprone and desferrioxamine successfully regresses severe heart failure in patients with beta-thalassemia major.
Cardiac complications caused by iron deposition are major causes of death in patients with beta-thalassemia major. Deferiprone (L1) was found to have greater efficacy at depleting myocardial iron than desferrioxamine (DFX). Furthermore, combined therapy with L1 and DFX produced an additive or synergistic iron chelating effect. We report the successful treatment of severe heart failure in two patients with beta-thalassemia major with the combined therapy. Magnetic resonance images showed a marked recovery of signal intensity in the heart, indicating a significant reduction of iron load in the heart. No significant adverse effects were noted. Therefore, combined therapy with L1 and DFX should be considered in patients with beta-thalassemia major and cardiac complications.
Wu
K H
KH
Department of Pediatrics, China Medical University Hospital, 2 Yuh-Der Road, North District, 404 Taichung, Taiwan.
Chang
J S
JS
Tsai
C H
CH
Peng
C T
CT
D000328:Adult; D002317:Cardiovascular Agents / Q000627:therapeutic use; D000077543:Deferiprone; D003676:Deferoxamine / Q000008:administration & dosage / Q000627:therapeutic use*; D048909:Diabetes Complications; D004359:Drug Therapy, Combination; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007006:Hypogonadism / Q000150:complications; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019190:Iron Overload / Q000150:complications / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D010024:Osteoporosis / Q000150:complications; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use*; D013156:Splenectomy; D065227:Transfusion Reaction; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D017086:beta-Thalassemia / Q000150:complications* / Q000601:surgery / Q000628:therapy
D002317:Cardiovascular Agents; D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D003676:Deferoxamine