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Korean guideline for iron chelation therapy in transfusion-induced iron overload
Jun Ho Jang1, Je-Hwan Lee, Sung-Soo Yoon
1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Korean patients with transfusion-induced iron overload now have access to deferasirox, an oral iron chelator. This guideline optimizes treatment for effective iron overload management and improved patient outcomes.
Area of Science:
- Hematology
- Pharmacology
Background:
- Transfusion-induced iron overload poses significant health risks, including organ damage, for Korean patients.
- Current chelation therapy often faces challenges with compliance and availability, leading to suboptimal treatment.
- Deferasirox offers a new, effective oral treatment option for managing iron overload.
Framework:
- The Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) developed a guideline for iron overload treatment.
- The guideline incorporates global consensus and local Korean data on iron chelation therapy.
- It provides recommendations for optimizing the use of deferasirox.
Implementation:
- Deferasirox is a once-daily oral iron chelator suitable for adult and pediatric patients.
- The recommended starting dose is 20 mg/kg body weight, taken on an empty stomach.
- Treatment aims to maintain serum ferritin levels below 1000 ng/mL.
Implications:
- Effective iron chelation therapy can prevent serious clinical sequelae and organ damage.
- Improved management strategies can enhance patient compliance and treatment efficacy.
- The guideline supports optimized care for Korean patients with transfusion-induced iron overload.
Abstract:
Many Korean patients with transfusion-induced iron overload experience serious clinical sequelae, including organ damage, and require lifelong chelation therapy. However, due to a lack of compliance and/or unavailability of an appropriate chelator, most patients have not been treated effectively. Deferasirox (DFX), a once-daily oral iron chelator for both adult and pediatric patients with transfusion-induced iron overload, is now available in Korea. The effectiveness of deferasirox in reducing or maintaining body iron has been demonstrated in many studies of patients with a variety of transfusion-induced anemias such as myelodysplastic syndromes, aplastic anemia, and other chronic anemias. The recommended initial daily dose of DFX is 20 mg/kg body weight, taken on an empty stomach at least 30 min before food and serum ferritin levels should be maintained below 1000 ng/mL. To optimize the management of transfusion-induced iron overload, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the general consensus on iron overload and the Korean data on the clinical benefits of iron chelation therapy, and developed a Korean guideline for the treatment of iron overload.
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