Hematopoietic recovery after administration of deferasirox for transfusional iron overload in a case of myelodysplastic syndrome.
Deferasirox (DFX) is a newly developed oral iron chelator that enables effective chelation with once daily administration. We describe here a case of transfusional-iron overloaded patient who experienced hematopoietic recovery after DFX administration. A 75-year-old woman with iron overload, who had been diagnosed with MDS (RCMD) and had received a transfusion of red blood cells and platelets regularly for 3 years, enrolled in the phase I clinical trial of ICL670 (DFX) in Japan. DFX administration steadily decreased her serum ferritin levels and chelated overloaded iron effectively. Interestingly, a year after initiation of the trial, she needed fewer blood transfusions, and no more transfusions after the 17th month of the trial. Even after suspending transfusions, her hemoglobin level and platelet count increased continuously, and she now has stable disease without blood transfusions. She has not received any specific treatment for MDS during this period. Examination of the bone marrow aspirates in the 35th month revealed dysplastic cells, indicating no remarkable change in the state of MDS. This case suggests that excess iron hampers hematopoiesis and that adequate iron chelation may improve hematological data in some iron-overloaded patients.
OKABE
Hiroshi
H
Division of Hematology, Department of Medicine, Jichi Medical University.
SUZUKI
Takahiro
T
OMORI
Tsukasa
T
MORI
Masaki
M
UEHARA
Eisuke
E
HATANO
Kaoru
K
UEDA
Masuzu
M
MATSUYAMA
Tomohiro
T
TOSHIMA
Masaki
M
QZAKI
Katsutoshi
K
NAGAI
Tadashi
T
MUROI
Kazuo
K
OZAWA
Keiya
K
D000368:Aged; D001565:Benzoates / Q000008:administration & dosage*; D000077588:Deferasirox; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006410:Hematopoiesis; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage*; D019190:Iron Overload / Q000188:drug therapy* / Q000209:etiology*; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000628:therapy*; D017713:Platelet Transfusion / Q000009:adverse effects*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*
D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox