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Published on: March 14, 2017
Dual Oral Iron Chelation (DOIC) in Children with Transfusion-Dependent Beta Thalassemia: Real-World Efficacy Data
Amitoj Singh Chadha1, Abaan Ul Haq Khazi Mohammad1, Naveen Kanth Dhãmi Nadakuditi1
1Department of Pediatric Hematology Oncology, St. Johns Medical College Hospital, Bangalore, India.
Insights
Dual oral iron chelation using deferiprone and deferasirox effectively reduces iron overload in children with transfusion-dependent thalassemia. This combination therapy is well-tolerated and significantly lowers ferritin levels, especially in patients with higher initial values.
Area of Science:
- Hematology
- Pediatric Medicine
- Pharmacology
Background:
- Iron overload is a common complication in children with Transfusion-dependent Thalassemia (TDT).
- Chelation therapy is essential for managing iron overload in TDT patients.
- Combination chelation with deferiprone (DFP) and deferasirox (DFX) offers a treatment option.
Purpose of the Study:
- To evaluate the efficacy and safety of dual oral iron chelation (DOIC) in children with TDT.
- To assess the impact of DOIC on serum ferritin levels over time.
- To identify factors influencing ferritin reduction with DOIC.
Main Methods:
- Retrospective chart review of TDT children initiated on DOIC between 2015 and 2022.
- Analysis of serum ferritin levels before and after DOIC initiation.
- Assessment of treatment duration and adverse effects.
Main Results:
- Forty-five children with TDT received DOIC.
- Mean serum ferritin decreased from 2929 ng/dl to 1962.10 ng/dl at 30 months.
- 82.22% of children achieved ferritin < 2000 ng/dl, and 60% achieved < 1000 ng/dl.
- Higher initial ferritin levels (> 2500 ng/dl) showed rapid reduction within 12-24 months.
- DOIC was well-tolerated with no severe adverse effects.
Conclusions:
- Dual oral iron chelation (DOIC) is an effective and safe treatment for reducing iron overload in children with TDT.
- DOIC leads to significant reductions in serum ferritin levels.
- The therapy is particularly effective in patients with high baseline ferritin levels and is well-tolerated.
Abstract:
Combination chelation with deferiprone (DFP) and deferasirox (DFX) is one of the treatment modalities for iron overload in children with Transfusion-dependent Thalassemia (TDT). We report our experience with dual oral iron chelation. Retrospective chart review was conducted on all children started on Dual Oral Iron Chelation (DOIC) from 2015 to 2022. Children with TDT requiring DOIC were included in the study. Forty-five children required DOIC. The mean SF before DOIC initiation was 2929 ng/dl (SD 1465.07). The mean ferritin following DOIC was 1962.10 ng/dl (SD 1165.83) at 30 months. Mean duration on DOIC was 44.6 months (IQR 60-30). With DOIC, 82.22% children had a fall in ferritin to < 2000 ng/dl and in 60% of them had fall to < 1000 ng/dL. Dual Oral Iron Chelation (DOIC) is efficacious in reducing ferritin in iron-overloaded patients. Higher ferritin values (> 2500 ng/dL) drop rapidly in the first 12-24 months. DOIC was well-tolerated with no severe adverse effects.
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