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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
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A double-blind, controlled, crossover trial of amlodipine on iron overload status in transfusion dependent

Hossein Karami1, Hadiseh Khalilzadeh Arjmandi2, Ebrahim Salehifar3

  • 1Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.

International Journal of Clinical Practice
|May 10, 2021
PubMed

Insights

Amlodipine may reduce iron overload in transfusion-dependent beta-thalassemia patients. This study showed amlodipine improved myocardial T2* and serum ferritin levels compared to placebo.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Transfusion-dependent beta-thalassemia (TDT) leads to iron overload.
  • Myocardial iron loading is a significant complication in TDT patients.
  • Effective strategies to manage iron overload in TDT are crucial.

Purpose of the Study:

  • To investigate the efficacy of amlodipine in improving myocardial iron loading in TDT patients.
  • To assess amlodipine's effect on serum ferritin levels.
  • To compare amlodipine's impact against a placebo in a crossover study design.

Main Methods:

  • A placebo-controlled, crossover study involving 19 TDT patients.
  • Patients received amlodipine (5 mg daily) or placebo for 6 months, followed by a 2-week washout.
  • Efficacy was measured using myocardial T2*-weighted MRI (magnetic resonance imaging) and serum ferritin levels.

Main Results:

  • Amlodipine treatment increased myocardial MRI T2* values from a baseline of 9.83 ± 2.67 ms to 11.44 ± 4.14 ms.
  • Placebo treatment resulted in a smaller increase in myocardial MRI T2* to 10.29 ± 4.01 ms.
  • Amlodipine demonstrated a significant improvement in both myocardial MRI T2* and serum ferritin levels compared to placebo.

Conclusions:

  • Amlodipine shows potential in improving myocardial iron loading and reducing serum ferritin in TDT patients.
  • The findings suggest amlodipine as a possible therapeutic option for managing iron overload in TDT.
  • Larger clinical trials are recommended to validate these preliminary results.
Abstract

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