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Increased survival and reversion of iron-induced cardiac disease in patients with thalassemia major receiving intensive combined chelation therapy as compared to desferoxamine alone.
Blood Cells Mol Dis ; 45(2): 136-9, 2010 Aug 15.
Article en En | MEDLINE | ID: mdl-20678715
ABSTRACT
Myocardial iron overload is the leading cause of death in patients with beta-thalassemia major. An intensification monotherapy with deferoxamine (DFO) as well as a combination therapy with DFO and deferiprone (DFP) reduces myocardial iron and improves cardiac function. However, the prognosis for thalassemia major patients with established cardiac disease switched from DFO monotherapy to combined DFP/DFO chelation is unknown. Twenty-eight thalassemia major patients with cardiac disease were enrolled in a prospective study lasting 42+/-6 months. Fifteen (9 high-ferritin and 6 low-ferritin) were placed on DFP/DFO (DFP, 75 mg/kg t.i.d.; DFO, 40-50mg/kg over 8-12h at night 5-7 days/week), while 13 (5 high- and 8 low-ferritin) received DFO alone. No cardiac events were observed among high-ferritin patients on combination therapy, whereas 4 cardiac events (p=0.0049), including three deaths, occurred in high-ferritin patients on DFO monotherapy. These findings demonstrate that in thalassemia major patients with well-established cardiac disease combined iron-chelation therapy with DFP/DFO is superior to DFO monotherapy.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Piridonas / Quelantes del Hierro / Talasemia beta / Deferoxamina / Quimioterapia Combinada / Cardiomiopatías Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Año: 2010 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Piridonas / Quelantes del Hierro / Talasemia beta / Deferoxamina / Quimioterapia Combinada / Cardiomiopatías Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Año: 2010 Tipo del documento: Article