title: Frequency of neutropenia among Turkish and Syrian pediatric thalassemia patients under deferiprone monotherapy.
abstract: Weekly monitoring of absolute neutrophil count (ANC) under deferiprone therapy in thalassemia patients is recommended to avoid agranulocytosis adverse event. Actually, this recommendation may not be applicable in clinical setting. Our study aimed to establish incidence of neutropenia under deferiprone (DFP) monotherapy when it was monitored bimonthly due to socioeconomic conditions effecting local and refugee thalassemic patients including Syrian origin (SYR; n = 26) and Turkish origin (TR; n = 26) groups. Patients on DFP were followed up for 12 months. Fifteen neutropenic episodes were seen in 5 patients. All 5 patients (4 from SYR group and 1 from TR group) had splenomegaly and hypersplenism, and neutropenia ceased in 4 patients after splenectomy despite continuation of deferiprone. In the TR group, the frequency of patients who have neutropenia (absolute neutrophil count [ANC] <1500/mm(3)) was 3.8% (n = 1) in the 1st month, no patients in TR group had neutropenia until 10th month when again there was 1 patient with mild neutropenia. In SYR group, the frequency of patients who have neutropenia was 3.8% (n = 1), 7.7% (n = 2), and 11.5% (n = 3) in the 1st, 2nd, and 3rd months, respectively, and was found to be 3.8% (n = 1) between 6 and 12 months. Whether or not DFP therapy should be interrupted in case of mild neutropenia and the frequency of monitoring ANC in real-life conditions should be documented with further studies. Other causes of neutropenia in DFP-treated patients should also be kept in mind.
authors.affiliation: a Department of Pediatric Hematology, İzmir Katip Celebi University Tepecik Training and Research Hospital , İzmir , Turkey.
authors.forename: Burcu Fatma
authors.initials: BF
authors.lastname: Belen
authors.affiliation: b Department of Pediatric Infectious Diseases, Gazi University Medical Faculty , Ankara , Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Polat
authors.affiliation: c Department of Pediatrics, Gaziantep Childrens' Hospital , Gaziantep , Turkey.
authors.forename: Sevinç Nursev
authors.initials: SN
authors.lastname: Özsevik
authors.affiliation: c Department of Pediatrics, Gaziantep Childrens' Hospital , Gaziantep , Turkey.
authors.forename: Esma
authors.initials: E
authors.lastname: Soylu
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D000743:Anemia, Hemolytic / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D001803:Blood Transfusion; D001855:Bone Marrow Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D000080983:Bone Marrow Failure Disorders; D002648:Child; D002675:Child, Preschool; D000077543:Deferiprone; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013593:Syria / Q000453:epidemiology; D013789:Thalassemia / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D014421:Turkey / Q000453:epidemiology
chemical_list: D011728:Pyridones; D000077543:Deferiprone
keywords: Hemoglobinopathies; neutropenia; pediatrics