title: Combination Iron Chelation Therapy with Deferiprone and Deferasirox in Iron-Overloaded Patients with Transfusion-Dependent β-Thalassemia Major.
abstract: There are few papers on the combination therapy of deferiprone (DFP) and deferasirox (DFX) in iron-overloaded patients with transfusion-dependent β-thalassemia major (β-TM). A total of 6 patients with β-TM (5 males and 1 female) with a mean age of 23.8±5.8 years (ranging from 17 to 31) used this treatment regimen. The mean doses of DFP and DFX were 53.9±22.2 and 29.3±6.8 mg/kg/day, respectively. The duration of treatment was 11.5±4.6 months. Their serum ferritin levels were measured to be 2800±1900 and 3400±1600 ng/mL before and after treatment, respectively (p<0.6). Their cardiac magnetic resonance imaging (MRI) T2* values were 16.69±15.35vs17.38±5.74 millisecond (ms) before and after treatment, respectively (p< 0.9). Although there was no significant difference between their cardiac MRI T2* values before and after treatment statistically, the values improved after combination therapy with DFP and DFX in most of the patients. Liver MRI T2 * values were changed from 2.12±0.98 to 3.03±1.51 ms after treatment (p < 0.01); Further, their liver T2* values and liver iron concentration (LIC) were improved after treatment. Our study found that cardiac MRI T2* values, liver MRI T2* values, and LIC were improved after combination therapy with DFP and DFX in β-TM patients and that DFP and DFX combination therapy could be used to alleviate cardiac and liver iron loading.
authors.affiliation: Department of Pediatrics, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences , Sari.
authors.forename: Hossein
authors.initials: H
authors.lastname: Karami
authors.affiliation: Department of Pediatrics, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences , Sari.
authors.forename: Mehrnoush
authors.initials: M
authors.lastname: Kosaryan
authors.affiliation: Student Research Committee, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences , Sari.
authors.forename: Arash Hadian
authors.initials: AH
authors.lastname: Amree
authors.affiliation: Student Research Committee, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences , Sari.
authors.forename: Hadi
authors.initials: H
authors.lastname: Darvishi-Khezri
authors.affiliation: Department of Anesthesiology, Babol University of Medical Sciences , Babol, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Mousavi
keywords: Deferiprone; MRI T2*; deferasirox; iron overload; β-thalassemia major