Effectiveness and safety of combined iron-chelation therapy with deferoxamine and deferiprone.
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.
Alymara
Vasiliki
V
Hematology Unit, University of Ioannina Medical School, Ioannina, Greece.
Bourantas
Dimitrios
D
Chaidos
Aristeidis
A
Bouranta
Paraskevi
P
Gouva
Maria
M
Vassou
Amalia
A
Tzouvara
Evagelia
E
Bourantas
Konstantinos L
KL
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*
D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D005293:Ferritins; D007501:Iron; D003676:Deferoxamine