A comparative study of deferasirox and deferiprone in the treatment of iron overload in patients with myelodysplastic syndromes.
One hundred thirteen patients with myelodysplastic syndromes (MDS) with <10% of bone marrow blasts received either deferiprone in a daily dose of 40-90 mg/kg (48 patients) or deferasirox in a daily dose of 10-40 mg/kg (65 patients). Median duration of treatment was 10,9 months for deferiprone and 13,7 months for deferasirox. A substantial reduction of iron stores evaluated as a decrease in serum ferritin of more than 50% of pretreatment level was achieved in 18 patients in deferasirox group (27.7%) but not in any patient treated with deferiprone, The incidence of adverse effects (mostly gastrointestinal symptoms) was similar after administration of both the drugs. The symptoms of deferasirox toxicity were mild and mostly transient and no drug related myelosuppresive effect was observed in contrast to deferiprone where agranulocytosis occurred in 4% of patients and the treatment had to be discontinued due to side effects in 20% of patients. The results confirmed the usefulness of deferasirox as an effective and safe iron chelator in MDS patients and indication of deferiprone as an alternative treatment only in patients with mild or moderate iron overload clearly not indicated for deferasirox.
Institute of Hematology and Blood Transfusion, U nemocnice 1, 128 20 Praha, Prague, Czech Republic. Electronic address: cermak@uhkt.cz.
Jaroslav
J
Cermak
Anna
A
Jonasova
Jana
J
Vondrakova
Libor
L
Cervinek
Petra
P
Belohlavkova
Radana
R
Neuwirtova
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001565:Benzoates / Q000627:therapeutic use*; D015913:Chelation Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D000077588:Deferasirox; D000077543:Deferiprone; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D011728:Pyridones / Q000627:therapeutic use*; D065227:Transfusion Reaction; D014230:Triazoles / Q000627:therapeutic use*
D001565:Benzoates; D007502:Iron Chelating Agents; D011728:Pyridones; D014230:Triazoles; D000077543:Deferiprone; D005293:Ferritins; D000077588:Deferasirox
Deferasirox, Chelation; Deferiprone; Myelodysplasia; Side effects; Toxicity