title: Effectiveness and safety of combined iron-chelation therapy with deferoxamine and deferiprone.
abstract: BACKGROUND
  The purpose of our study was to evaluate the effectiveness and safety of combined therapy with deferoxamine (DFO) and deferiprone (DFP) in patients with beta-thalassemia major and increased serum ferritin.
  
  
  METHODS
  Our study was performed in 36 patients with beta-thalassemia major. DFP was administered orally in a total daily dose of 60 mg/kg for 6 days per week and DFO was administered subcutaneously in a total daily dose of 40-50 mg/kg for 4-6 days per week. The efficacy of combined treatment was assessed by measurements of serum ferritin and 24-h urine iron excretion levels.
  
  
  RESULTS
  Out of the 36 patients, 11 discontinued DFO after a mean of 4 months; however, 25 patients, who continued to receive the combined therapy showed a very satisfactory compliance. After a mean of 13.5 months, their mean serum ferritin levels reduced from 2637 + 1292 to 1580 + 1024 ng/ml (P = 0.002) and their mean urinary iron excretion elevated from 0.41 + 0.27 to 0.76 +0.49 mg/24h (P = 0.003). The observed side effects were gastrointestinal disorders,elevations in liver enzymes, mild neutropenia, joint symptoms, taste disorders, dizziness and fatigue.
  
  
  CONCLUSIONS
  The results of this study show that combined iron-chelation therapy with DFO and DFP results in satisfactory reduction of serum ferritin with no significant toxicity.
authors.affiliation: Hematology Unit, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Alymara
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Bourantas
authors.forename: Aristeidis
authors.initials: A
authors.lastname: Chaidos
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Bouranta
authors.forename: Maria
authors.initials: M
authors.lastname: Gouva
authors.forename: Amalia
authors.initials: A
authors.lastname: Vassou
authors.forename: Evagelia
authors.initials: E
authors.lastname: Tzouvara
authors.forename: Konstantinos L
authors.initials: KL
authors.lastname: Bourantas
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000077543:Deferiprone; D003676:Deferoxamine / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005293:Ferritins / Q000097:blood / Q000187:drug effects; D006801:Humans; D007279:Injections, Subcutaneous; D007501:Iron / Q000652:urine; D007502:Iron Chelating Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011728:Pyridones / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000188:drug therapy*
chemical_list: D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D005293:Ferritins; D007501:Iron; D003676:Deferoxamine