Sensorimotor neurotoxicity associated with high-dose deferoxamine treatment

Area of Science:

• Hematology
• Neuroscience
• Pharmacology

Background:

• Iron overload is a common complication in beta-thalassemia patients.
• Deferoxamine (DFO) is a standard treatment for iron overload.
• DFO therapy can be associated with various toxicities.

Observation:

• Two beta-thalassemia patients developed sensorimotor neurotoxicity while on high-dose intravenous DFO (120 mg/kg/day).
• Neurotoxicity onset occurred after 5 and 6 months of treatment.
• Symptoms resolved upon DFO discontinuation and recurred in one patient upon re-initiation.

Findings:

• High-dose DFO can induce reversible sensorimotor neurotoxicity.
• The neurotoxicity did not correlate with serum ferritin levels or DFO dose-to-ferritin ratio.
• This adds to known auditory and visual neurotoxicities of DFO.

Implications:

• Clinicians should monitor for sensorimotor neurotoxicity in patients receiving high-dose DFO.
• Discontinuation of DFO is recommended at the onset of neurotoxicity.
• Lower DFO doses may be considered for re-initiation of therapy if necessary.