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Combined therapy with deferiprone and desferrioxamine
B Wonke1, C Wright, A V Hoffbrand
1Department of Haematology, Whittington Hospital, London.
British Journal of Haematology
|November 25, 1998
Summary
Increasing deferiprone dosage or combining it with desferrioxamine improves iron chelation in transfusion-dependent patients when standard doses are inadequate. These methods showed reduced serum ferritin levels without significant side effects.
Area of Science:
- Hematology
- Pharmacology
- Internal Medicine
Background:
- Iron overload is a common complication in transfusion-dependent patients.
- Standard deferiprone doses (75 mg/kg/day) are sometimes insufficient for effective iron chelation.
Purpose of the Study:
- To evaluate methods for improving iron chelation therapy in patients with inadequate response to standard deferiprone doses.
- To assess the efficacy and safety of increasing deferiprone dosage and combination therapy with desferrioxamine.
Main Methods:
- A study involving 13 transfusion-dependent patients.
- Group 1: Nine patients had their daily deferiprone dose increased (83-100 mg/kg).
- Group 2: Five patients received combined therapy of deferiprone and subcutaneous desferrioxamine (2-6 days/week).
Main Results:
- Increasing deferiprone dose led to a significant fall in serum ferritin in all nine patients (P = 0.0022).
- Combined therapy resulted in a fall in serum ferritin in all five patients after 7-15 months (P=0.0791).
- No drug-related toxic side-effects were observed in either group.
Conclusions:
- Increasing deferiprone dosage or combining it with desferrioxamine can enhance iron chelation efficacy.
- These strategies offer improved management for patients with inadequate iron chelation.
- Further extensive trials are needed to confirm long-term safety and efficacy.