title: Iron chelation with deferasirox for the treatment of secondary hemosiderosis in pediatric oncology patients: a single-center experience.
abstract: Pediatric oncology patients are often iron overloaded, due to the multiple blood transfusions necessary during the course of chemotherapy. Our aim is to report the efficacy and safety of deferasirox, an oral iron chelator, in this patient group. Deferasirox was administered to 13 children with malignancies in remission and iron overload. Ferritin, blood urea nitrogen, creatinine, transaminases, and bilirubin were recorded at 4- to 8-week intervals, and hepatic and cardiac iron overload were assessed with magnetic resonance imaging before initiation of treatment. Deferasirox was administered for an average of 6 months (SD=4.5; range, 0.3 to 18.2). Two children presented with skin rash, 1 with gastrointestinal disturbances, and 1 with fully reversible acute renal failure. The mean monthly rate of change in ferritin levels was -10.8 μg/L before initiation of treatment (95% confidence interval [CI], -19.8 to -1.8; P=0.02) and -93.6 μg/L during deferasirox treatment (95% CI, -118.1 to -69.1; P<0.001). The difference in the monthly rate of change in ferritin levels before and after treatment initiation was -82.8 μg/L (95% CI, -111.6 to -53.9; P<0.001). Deferasirox was effective in reducing the iron burden. The adverse effects were easily monitored and managed. Further studies are warranted to investigate the effect of deferasirox on mortality and morbidity in this population.
authors.affiliation: Hematology-Oncology Unit, First Department of Pediatrics, University of Athens, Aghia Sofia Children's Hospital, Athens, Greece.
authors.forename: Yiouli P
authors.initials: YP
authors.lastname: Ktena
authors.forename: Anastasia
authors.initials: A
authors.lastname: Athanasiadou
authors.forename: George
authors.initials: G
authors.lastname: Lambrou
authors.forename: Maria
authors.initials: M
authors.lastname: Adamaki
authors.forename: Maria
authors.initials: M
authors.lastname: Moschovi
mesh_terms: D000293:Adolescent; D001565:Benzoates / Q000627:therapeutic use*; D015913:Chelation Therapy; D002648:Child; D002675:Child, Preschool; D000077588:Deferasirox; D005260:Female; D005293:Ferritins / Q000097:blood; D006486:Hemosiderosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007501:Iron; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D065227:Transfusion Reaction; D014230:Triazoles / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D007501:Iron; D000077588:Deferasirox