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The new era of chelation treatments: effectiveness and safety of 10 different regimens for controlling iron overloading in thalassaemia major
Author(s) -
Di Maggio Rosario,
Maggio Aurelio
Publication year - 2017
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14712
Subject(s) - deferiprone , chelation therapy , medicine , chelation , deferoxamine , heart failure , ferritin , thalassemia , gastroenterology , chemistry , organic chemistry
Summary This review outlines the effectiveness and safety of 10 different regimens for controlling iron overloading in thalassaemia major ( TM ). For each treatment, the strength of the evidence was documented according to the guidelines of the American College of Cardiology and the American Heart Association. Serum ferritin ( SF ), liver iron concentration ( LIC ), heart T2* signal, heart damage and survival were used to assess effectiveness. Five chelation regimens out of 10 showed Level A Evidence in controlling iron overloading, as determined by SF levels and LIC . Three out of 10 chelation regimens were able to control heart iron levels, as determined by T2* signals with Level A Evidence. Two chelation regimens were able to improve/reverse heart damage and four increased of survival with Level B Evidence. These advances mean that the current survival of TM patients is now similar to that of thalassaemia intermedia patients.