Document Detail


Deferasirox treatment for myelodysplastic syndromes: "real-life" efficacy and safety in a single-institution patient population.
MedLine Citation:
PMID:  22569854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We here describe a single-institution experience on 40 patients with myelodysplastic syndromes (MDS) consecutively treated with deferasirox at the dose of 10-30 mg/kg/day according to Consensus Guidelines on Iron Chelation Therapy, outside of clinical trials. Serum ferritin (SF) was measured monthly, and safety assessment included monitoring of adverse events during treatment and of liver and renal parameters. Median SF at baseline of the 40 patients was 2,878 ng/ml. Median dose of deferasirox was 1,125 mg/day. At a median follow-up of 12 months of treatment, there was a significant reduction in SF from baseline, the median value being 1,400 ng/ml (p = 0.001). Interruptions due to toxicity were recorded in 40 % of patients: most common adverse events were diarrhoea (five patients, 12.5 %) and skin rash (four patients, 10 %). Seven patients had increased serum creatinine values >33 % above baseline, but there were no progressive increases. Four patients (three refractory anaemia and one refractory anaemia with excess blasts type 1) had a reduction of transfusion requirement (from a median of 5 to 1 unit/month) according to International Working Group 2006 criteria, with mean Hb value increasing from 8.5 to 10.5 g/dl, and mean Hb improvement being 2 g/dl (p = 0.02). No increased toxicity was noted when deferasirox was used concomitantly with azacitidine (eight patients who were intermediate 2 International Prognostic Scoring System risk) or lenalidomide (two patients with del(5q)). In conclusion, the oral iron chelator deferasirox is effective and safe when used in MDS patients with transfusion requirement, also if administered concomitantly with other drugs.
Authors:
Massimo Breccia; Paola Finsinger; Giuseppina Loglisci; Vincenzo Federico; Michelina Santopietro; Gioia Colafigli; Luigi Petrucci; Adriano Salaroli; Alessandra Serrao; Roberto Latagliata; Giuliana Alimena
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Publication Detail:
Type:  Journal Article     Date:  2012-05-09
Journal Detail:
Title:  Annals of hematology     Volume:  91     ISSN:  1432-0584     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-06     Completed Date:  2012-10-23     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1345-9     Citation Subset:  IM    
Affiliation:
Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. breccia@bce.uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antimetabolites / therapeutic use
Azacitidine / therapeutic use
Benzoates / administration & dosage,  adverse effects,  therapeutic use*
Chelating Agents / administration & dosage,  adverse effects,  therapeutic use*
Drug Eruptions / etiology
Drug Evaluation
Drug Therapy, Combination
Female
Follow-Up Studies
Gastrointestinal Diseases / chemically induced
Hematinics / adverse effects,  therapeutic use
Humans
Iron Overload / prevention & control
Kidney Diseases / chemically induced
Male
Middle Aged
Myelodysplastic Syndromes / drug therapy*
Retrospective Studies
Thalidomide / analogs & derivatives,  therapeutic use
Treatment Outcome
Triazoles / administration & dosage,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antimetabolites; 0/Benzoates; 0/Chelating Agents; 0/Hematinics; 0/Triazoles; 191732-72-6/lenalidomide; 320-67-2/Azacitidine; 50-35-1/Thalidomide; V8G4MOF2V9/deferasirox

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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