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Related Experiment Videos

Growth failure and bony changes induced by deferoxamine.

N F Olivieri1, G Koren, J Harris

  • 1Division of Haematology/Oncology, Hospital for Sick Children, University of Toronto, Ontario, Canada.

The American Journal of Pediatric Hematology/Oncology
|January 1, 1992
PubMed
Summary

Deferoxamine therapy in children with beta thalassemia can cause growth failure and bone abnormalities, particularly when initiated before age two. This impacts linear growth and growth plate morphology.

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Area of Science:

  • Pediatric Endocrinology
  • Hematology
  • Bone Biology

Background:

  • Beta-thalassemia requires iron chelation therapy to manage transfusional iron overload.
  • Deferoxamine mesylate is a primary treatment for iron overload in thalassemia patients.
  • Growth impairment is a known complication in children with beta-thalassemia.

Purpose of the Study:

  • To investigate the impact of nightly subcutaneous deferoxamine therapy on linear growth and growth plate morphology in children with homozygous beta-thalassemia.
  • To determine if deferoxamine therapy is a causative factor in growth failure and associated bony changes.
  • To identify potential risk factors, such as age at initiation of therapy, associated with deferoxamine-induced growth impairment.

Main Methods:

  • Retrospective review of children with homozygous beta-thalassemia receiving nightly subcutaneous deferoxamine.

Related Experiment Videos

  • Analysis of monthly height percentiles before and for 36 months after therapy initiation.
  • Assessment of growth plate morphology, specifically in distal ulnar, radial, and tibial metaphyses.
  • Comparison of growth patterns between patients initiating deferoxamine before age 2 versus after age 5.

    • Main Results:

    • 11 of 37 patients showed marked growth plate abnormalities and a significant decline in height percentile.
    • These 11 patients received higher deferoxamine doses and had lower mean serum ferritin levels.
    • Patients initiating deferoxamine before age 2 demonstrated a significant decline in height percentile by year three, implicating the therapy.

    Conclusions:

    • Deferoxamine therapy is directly related to both the decline in height percentile and observed bony changes in well-chelated patients.
    • Early initiation of deferoxamine therapy (before age 2) is associated with a greater risk of growth failure.
    • Growth plate abnormalities in the metaphyses are a key finding in patients experiencing deferoxamine-induced growth impairment.