A SAFETY AND EFFICACY OF COMBINATION THERAPY OF DEFERASIROX AND DEFEROXAMINE VERSUS DEFERASIROX FOR TREATMENT OF TRANSFUSIONAL IRON OVERLOAD IN SICKLE CELL ANEMIA IN AL-NAJAF AND BABYLON PROVINCE IN IRAQ
Abstract
Background:- In Sickle cell anemia, transfusions improve blood flow by reducing the proportion of red cells capable of forming sickle hemoglobin polymer. This limits hemolysis and endothelial damage and repeated blood transfusion leading to iron overload or transfusion hemosiderosis, the only way to prevent this are by long-term chelation therapy.
Objectives: - The aim of this study is to assess the efficacy and safety of combination therapy in a group of patients with sickle cell anemia.
Patients and method:- The prospective study was done on sixty-five patients with the sickle cell anemia, conducted to Al-Najaf and Babylon thalassemia centers, classify into two groups, those on combined therapy of Deferoxamine-Deferasirox treatment as the second group, while on Deferasirox alone as the first group and its aim to assess the safety of the combined treatment.
Results: - Both regimens proved to have less adverse effects on hepatic or renal function and pellet count. The degree of reduction of serum ferritin is significantly higher with combined Deferoxamine-Deferasirox therapy. Conclusion: - combined chelating agents have a significant effect on serum ferritin, with an acceptable level of safety.
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References
MeerpohI JJ , Antes G , Rucker G, et-al : Deferasirox for managing transfusional iron overload in people with sickle cell disease: The Cochrane collaboration, 2010, issue 8 ;p 15.
Radha Raghupathy, Deepa Manwani and Jane A. little: Iron overload in sickle cell disease: Advance in hematology, volume 2010, and article ID 272940, Page 3-16.
Stuart MJ, Nagel R L, Sickle cell disease.Lancet 2004; 364; 1343-60
Oliveiri NF: Progression of iron over load in sickle cell anemia: Semin Hematolm 2003; 38; 57-62.
Kirkham FJ, DeBaun MR. Stroke in children with sickle cell disease. Curr Treat Options Neurol 2004; 6(5):357-756-5-
Cappellini MD, Bejaoui M, Agaoglu L, et al., Prospective evaluation of patient reported outcomes during treatment with deferasirox or deferoxamine for iron overload in patients with beta-thalassemia, Clin Ther,2007;29:909–17.
Porter J, Rees D ,Shah f , Thein SL : Clinical practice with deferasirox reflection on Patients management in the UK :BMJ:27 september 2008 .
VanOrden HE, Hagemann TM. Deferasirox -an oral agent for chronic iron overload. AnnPharmacother2006; 40:1110-7.
Vichinsky E, Onyekwere O, Poter J, et al: A randomized comparison of Deferasirox for the treatment of transfusional iron overload in sickle cell Disease: BJ hematology 2006: 136: 501-8.
Adam R J: Management of iron toxicity in sickle cell disease: Iron Journal club, Volume 3, no. 2, 2009, p.18-21.
- Origa R, Bina P, Agus A, Crobu G, Defraia E, and Dessì C, et al.: Combined therapy with deferiprone and desferrioxamine in thalassemia major. Haematologica 2005; 90:
Cappellini MD, Overcoming the challenge of patient compliance with iron chelation therapy, Semin Hematol, 2005; 42:S19–21
- Cohen AR. New Advances in Iron Chelation Therapy. Hematology 2006; 42-47 effectiveness of long-term therapy with the oral deferiprone. Blood, 2003.102:1583.
- Cohn AR, Galanello R, Piga A, et-al: safety and effectiveness of long term Therapy with oral deferiprone: blood, 2003. 102: 1583-7.
- Aydinok Y, Nisli G, Kavakli K, et-al: sequential use of deferiprone and deferoxamine in primary school children with thalassemia major in turkey: Actahaematologica 1999:102:17.
