title: Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders.
abstract: New measures of iron accumulation in liver and heart (superconducting quantum inference device and magnetic resonance imaging), and oral iron chelators (deferiprone and deferasirox) are available for managing iron overload in thalassemia major. To assure appropriate use of these new health technologies, the Italian Society of Hematology appointed a panel of experts to produce clinical practice-guidelines for the management of iron overload in thalassemia major and related disorders. The analytical hierarchy process, a technique for multicriteria decision analysis, was applied to relevant key questions in order to identify the alternative strategies, generate explicit criteria for their evaluation, and check how well the alternatives fulfilled the criteria. The result of a comprehensive systematic review of articles released from 1990 to 2007 was used as a source of scientific evidence to compare the decisional options pairwise, and select the final recommendation. Every step in the model was developed from questionnaires and group discussion. The resulting recommendations advise about which examination to carry out in order to plan iron chelation therapy, when to start iron chelation, which iron chelator to choose in regularly transfused patients, how to monitor iron chelation therapy, and when and how to switch standard therapy.
authors.affiliation: Hematology Department and BMT Unit, Cancer Center "Armando Businco", viale Edward Jenner, 09121 Cagliari, Italy. emnang@tin.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Angelucci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barosi
authors.forename: Clara
authors.initials: C
authors.lastname: Camaschella
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Cappellini
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.forename: Renzo
authors.initials: R
authors.lastname: Galanello
authors.forename: Monia
authors.initials: M
authors.lastname: Marchetti
authors.forename: Antonio
authors.initials: A
authors.lastname: Piga
authors.forename: Sante
authors.initials: S
authors.lastname: Tura
mesh_terms: D000293:Adolescent; D000328:Adult; D001565:Benzoates / Q000627:therapeutic use; D002648:Child; D003661:Decision Support Techniques; D000077588:Deferasirox; D000077543:Deferiprone; D003676:Deferoxamine / Q000627:therapeutic use; D006405:Hematology / Q000379:methods* / Q000639:trends; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use; D019190:Iron Overload / Q000628:therapy*; D008099:Liver / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011728:Pyridones / Q000627:therapeutic use; D017262:Siderophores / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D017086:beta-Thalassemia / Q000628:therapy*
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D011728:Pyridones; D017262:Siderophores; D014230:Triazoles; D000077543:Deferiprone; D003676:Deferoxamine; D000077588:Deferasirox