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Comparison of oral iron chelators in the management of transfusion-dependent ß-thalassemia major based on serum ferritin and liver enzymes.
Yusuf, Sulaiman; Herdata, Heru Noviat; Edward, Eka Destianti; Khairunnisa, Khairunnisa.
Afiliação
  • Yusuf S; Division of Gastroenterohepatology, Department of Pediatrics, School of Medicine, Universitas Syiah Kuala - Dr. Zainoel Abidin Hospital, Banda Aceh, 23111, Indonesia.
  • Herdata HN; Division of Hematology-Oncology, Department of Pediatrics, School of Medicine, Universitas Syiah Kuala - Dr. Zainoel Abidin Hospital, Banda Aceh, 32111, Indonesia.
  • Edward ED; Division of Hematology-Oncology, Department of Pediatrics, School of Medicine, Universitas Syiah Kuala - Dr. Zainoel Abidin Hospital, Banda Aceh, 32111, Indonesia.
  • Khairunnisa K; Department of Pediatrics, School of Medicine, Universitas Syiah Kuala - Dr. Zainoel Abidin Hospital, Banda Aceh, 23111, Indonesia.
F1000Res ; 12: 154, 2023.
Article em En | MEDLINE | ID: mdl-39233713
ABSTRACT

Background:

Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in ß-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in ß-thalassemia major patients.

Methods:

A cross-sectional observation was performed on 102 patients with ß-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman's rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators' effects between those receiving short-term (≤7 years) and long-term (>7 years) blood transfusion were also analyzed.

Results:

The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 and p<0.001) and AST ((r=0.569; p<0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups ( p=0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group ( p=0.001 and 0.022, respectively). Total ( p<0.001), indirect ( p<0.001), and direct bilirubin levels ( p=0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance of p=0.008 in the long-term transfusions group.

Conclusions:

Ferritin is high in people with transfusion-dependent ß-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transfusão de Sangue / Quelantes de Ferro / Talassemia beta / Ferritinas / Deferiprona / Deferasirox / Fígado Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: F1000Res Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transfusão de Sangue / Quelantes de Ferro / Talassemia beta / Ferritinas / Deferiprona / Deferasirox / Fígado Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: F1000Res Ano de publicação: 2023 Tipo de documento: Article