title: Phase IV open-label study of the efficacy and safety of deferasirox after allogeneic stem cell transplantation.
abstract: This is the first prospective study of deferasirox in adult allogeneic hematopoietic stem cell transplant recipients with transfusional iron overload in hematologic malignancies. Patients at least six months post transplant were treated with deferasirox at a starting dose of 10 mg/kg/day for 52 weeks or until serum ferritin was less than 400 ng/mL on two consecutive occasions. Thirty patients were enrolled and 22 completed the study. A significant reduction from baseline in median serum ferritin and in liver iron concentration at 52 weeks was observed in the overall population: from 1440 to 755.5 ng/mL (P=0.002) and from 14.5 to 4.6 mg Fe/g dw (P=0.0007), respectively. Reduction in serum ferritin in patients who did not discontinue deferasirox therapy was significantly greater than that found in those who prematurely discontinued the treatment (from 1541 to 581 ng/mL vs. from 1416 to 1486 ng/mL; P=0.008). Drug-related adverse events, reported in 17 patients (56.7%), were mostly mild to moderate in severity. There were no drug-related serious adverse events. Twelve patients (40.0%) showed an increase of over 33% in serum creatinine compared to baseline and greater than the upper limit of normal on two consecutive visits. Two patients (6.7%) with active graft-versus-host disease showed an increase in alanine aminotransferase exceeding 10 times upper limit of normal; both resolved. In this prospective study, deferasirox provided a significant reduction in serum ferritin and liver iron concentration over one year of treatment in allogeneic hematopoietic stem cell transplant recipients with iron overload. In addition, the majority of adverse events related to deferasirox were mild or moderate in severity. (clinicaltrials.gov identifier:01335035).
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Spain carlosvallej@me.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Vallejo
authors.affiliation: Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Batlle
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Vázquez
authors.affiliation: Hospital Clínico Universitario-INCLIVA, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Solano
authors.affiliation: Hospital Son Dureta, Palma de Mallorca, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Sampol
authors.affiliation: Catalan Institute of Oncology-Idibell, L'Hospitalet de Llobregat, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Duarte
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Hernández
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.affiliation: Hospital Clínic i Provincial de Barcelona, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
authors.affiliation: Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Jiménez
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: ERESA, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Belloch
authors.affiliation: Novartis Farmacéutica S.A., Barcelona, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Jiménez
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Isidro
authors.initials: I
authors.lastname: Jarque
mesh_terms: D000328:Adult; D000368:Aged; D001565:Benzoates / Q000009:adverse effects / Q000627:therapeutic use*; D000077588:Deferasirox; D005260:Female; D005293:Ferritins / Q000097:blood; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D000077588:Deferasirox