title: Deferoxamine versus combined therapy for chelating liver, spleen and bone marrow iron in beta-thalassemic patients: a quantitative magnetic resonance imaging study.
abstract: We used magnetic resonance imaging (MRI) to compare the effect of iron chelation on liver, spleen and bone marrow. We examined 21 beta-thalassemic patients undergoing deferoxamine (DFO) (9/21) or combined therapy [DFO and deferiprone (L1), 12/21] with two abdominal MRI studies using T1-w/Pd-w/T2*-wGRE and T1-wTSE sequences. Changes in serum ferritin (DF%), and liver, spleen and marrow to paraspinous muscles signal intensity ratios (SI) in T1-wTSE sequence were calculated as D%=[(2(nd)value-1(st) value)/1(st) value] x100%. Negative DF% and positive D(SI)% indicated reduction of iron. Although 17/21 (80.9%) patients demonstrated reduction in ferritin, only 8/21 (38%), 7/21 (33.3%) and 7/21 (33.3%) patients had decreased liver, spleen and marrow iron. Patients undergoing combined therapy showed significantly greater reduction (Student's t-test, p < 0.05) or less increase (t-test, p <0.05) in iron stores. Combined therapy is more effective than DFO for removing and preventing liver, spleen and bone marrow iron accumulation in beta-thalassemic patients. Magnetic resonance imaging is valuable for organ-specific monitoring of chelation therapy.
authors.affiliation: Department of Radiology, University of Crete, Heraklion, Greece. drakonaki@yahoo.gr
authors.forename: Eleni E
authors.initials: EE
authors.lastname: Drakonaki
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Maris
authors.forename: Stella
authors.initials: S
authors.lastname: Maragaki
authors.forename: Vaggelis
authors.initials: V
authors.lastname: Klironomos
authors.forename: Alex
authors.initials: A
authors.lastname: Papadakis
authors.forename: Apostolos H
authors.initials: AH
authors.lastname: Karantanas
mesh_terms: D001853:Bone Marrow / Q000378:metabolism; D015913:Chelation Therapy; D000077543:Deferiprone; D003676:Deferoxamine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005293:Ferritins / Q000097:blood / Q000172:deficiency / Q000378:metabolism*; D006801:Humans; D007501:Iron; D008099:Liver / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use*; D013154:Spleen / Q000378:metabolism; D017086:beta-Thalassemia / Q000188:drug therapy* / Q000378:metabolism*
chemical_list: D011728:Pyridones; D000077543:Deferiprone; D005293:Ferritins; D007501:Iron; D003676:Deferoxamine