Document Detail


Deferasirox, deferiprone and desferrioxamine treatment in thalassemia major patients: cardiac iron and function comparison determined by quantitative magnetic resonance imaging.
MedLine Citation:
PMID:  20884710     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Oral deferiprone was suggested to be more effective than subcutaneous desferrioxamine for removing heart iron. Oral once-daily chelator deferasirox has recently been made commercially available but its long-term efficacy on cardiac iron and function has not yet been established. Our study aimed to compare the effectiveness of deferasirox, deferiprone and desferrioxamine on myocardial and liver iron concentrations and bi-ventricular function in thalassemia major patients by means of quantitative magnetic resonance imaging.
DESIGN AND METHODS: From the first 550 thalassemia subjects enrolled in the Myocardial Iron Overload in Thalassemia network, we retrospectively selected thalassemia major patients who had been receiving one chelator alone for longer than one year. We identified three groups of patients: 24 treated with deferasirox, 42 treated with deferiprone and 89 treated with desferrioxamine. Myocardial iron concentrations were measured by T2* multislice multiecho technique. Biventricular function parameters were quantitatively evaluated by cine images. Liver iron concentrations were measured by T2* multiecho technique.
RESULTS: The global heart T2* value was significantly higher in the deferiprone (34 ± 11 ms) than in the deferasirox (21 ± 12 ms) and the desferrioxamine groups (27 ± 11 ms) (P = 0.0001). We found higher left ventricular ejection fractions in the deferiprone and the desferrioxamine versus the deferasirox group (P = 0.010). Liver iron concentration, measured as T2* signal, was significantly lower in the desferrioxamine versus the deferiprone and the deferasirox group (P = 0.004).
CONCLUSIONS: The cohort of patients treated with oral deferiprone showed less myocardial iron burden and better global systolic ventricular function compared to the patients treated with oral deferasirox or subcutaneous desferrioxamine.
Authors:
Alessia Pepe; Antonella Meloni; Marcello Capra; Paolo Cianciulli; Luciano Prossomariti; Cristina Malaventura; Maria Caterina Putti; Alma Lippi; Maria Antonietta Romeo; Maria Grazia Bisconte; Aldo Filosa; Vincenzo Caruso; Antonella Quarta; Lorella Pitrolo; Massimiliano Missere; Massimo Midiri; Giuseppe Rossi; Vincenzo Positano; Massimo Lombardi; Aurelio Maggio
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-30
Journal Detail:
Title:  Haematologica     Volume:  96     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-05-26     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Affiliation:
Magnetic Resonance Imaging Unit, Fondazione G. Monasterio, C.N.R. - Regione Toscana, Pisa, Italy. alessia.pepe@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Benzoates / therapeutic use*
Child
Deferoxamine / therapeutic use*
Drug Therapy, Combination
Female
Humans
Iron / metabolism*
Iron Chelating Agents / therapeutic use
Iron Overload / chemically induced,  drug therapy
Magnetic Resonance Imaging*
Male
Middle Aged
Prognosis
Pyridones / therapeutic use*
Retrospective Studies
Siderophores / therapeutic use
Triazoles / therapeutic use*
Ventricular Function / drug effects*
Young Adult
beta-Thalassemia / drug therapy*
Chemical
Reg. No./Substance:
0/Benzoates; 0/Iron Chelating Agents; 0/Pyridones; 0/Siderophores; 0/Triazoles; 2BTY8KH53L/deferiprone; 70-51-9/Deferoxamine; 7439-89-6/Iron; V8G4MOF2V9/deferasirox
Comments/Corrections
Comment In:
Haematologica. 2011 Jan;96(1):5-8   [PMID:  21193427 ]
Haematologica. 2011 Feb;96(2):e5-6; author reply e7-8   [PMID:  21282714 ]

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