Effect of deferiprone on liver iron overload and fibrosis in hepatitis-C-virus-infected thalassemia.
To assess the effects of liver iron overload and fibrosis after treatment with a chelating agent in hepatitis C virus (HCV)-infected thalassemia, from April 1999 to July 2004, 45 patients with thalassemia major (age range 9-33 years, mean 19.3) received daily deferiprone (L1) for 23-60 months (75 mg/kg). The patients were divided into two groups on the basis of their hepatitis status (27 with, 18 without). Their serum was analyzed for alanine aminotransferase (GPT), aspartate aminotransferase (GOT), bilirubin (total/direct), r-glutamyl transpeptidase (r-GT), alkaline phosphatase (Alk-P), and ferritin. Liver iron overload and fibrosis were defined by a senior pathologist. No significant differences were demonstrated in serum levels of GPT, GOT, bilirubin, r-GT, Alk-P or ferritin; comparison was made for each group before and after L1 treatment. Iron scores were 2.3 +/- 0.9 and 2.8 +/- 0.9 for the hepatitis C negative and positive groups, respectively (p = 0.07), with liver fibrosis scores of 1.0 +/- 0.5 and 0.4 +/- 0.52 (p = 0.56). The two scores were not higher for the positive group. There was no evidence of: 1) greater iron overload and fibrosis in the HCV-infected thalassemic patients; 2) L1 inducing progressive hepatic fibrosis or worsening iron overload in HCV-infected thalassemic patients after long-term therapy; 3) further damage to liver cells associated with L1 treatment.
Chen
An-Chyi
AC
Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan.
Peng
Ching-Tien
CT
Wu
Shu-Fen
SF
Wu
Kang-Hsi
KH
Chiang
I-Ping
IP
Tsai
Chang-Hai
CH
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015913:Chelation Therapy; D002648:Child; D003131:Combined Modality Therapy; D000077543:Deferiprone; D004341:Drug Evaluation; D005260:Female; D005293:Ferritins / Q000097:blood; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy*; D008099:Liver / Q000737:chemistry / Q000187:drug effects* / Q000201:enzymology; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011728:Pyridones / Q000627:therapeutic use*; D012189:Retrospective Studies; D013789:Thalassemia / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D065227:Transfusion Reaction; D005723:gamma-Glutamyltransferase / Q000097:blood
D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D005293:Ferritins; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase