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Four‐year evaluation of myocardial and liver iron assessed prospectively with serial MRI scans in young patients with β‐thalassaemia major: comparison between different chelation regimens
Author(s) -
Christoforidis Athanasios,
Haritandi Afroditi,
Tsatra Ioanna,
Tsitourides Ioannis,
Karyda Stavroula,
AthanassiouMetaxa Miranda
Publication year - 2007
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.0902-4441.2006.t01-1-ejh3013.x
Subject(s) - deferiprone , medicine , liver biopsy , magnetic resonance imaging , chelation therapy , deferoxamine , hemochromatosis , gastroenterology , ferritin , biopsy , radiology , nuclear medicine , thalassemia
This study was conducted in order to assess myocardial and liver iron concentrations (LICs) using serial magnetic resonance imaging (MRI) scans in patients with β‐thalassaemia major, over a 4‐yr period, and consequently to compare the effectiveness of different chelation regimens. Fifty children and young adults with β‐thalassaemia major (27 boys and 23 girls) were recruited (mean age: 14.74 ± 3.67 yr). All patients underwent detailed clinical examination, electrocardiography, echocardiography, myocardial and liver MRI at the beginning of the study, 2 and 4 yr after. Additionally, serum ferritin levels were regularly measured and data regarding LICs assessed by percutaneous liver biopsy were available in 26 patients. Both myocardial and liver MRI values showed a moderate inverse correlation with age ( r = −0.379, P < 0.001 and r = −0.376, P < 0.001, respectively). Liver MRI was better correlated with serum ferritin concentrations ( r = −0.342, P < 0.001) than myocardial MRI ( r = −0.186, P = 0.011). Liver MRI values were highly correlated with LICs derived from percutaneous liver biopsy ( r = −0.863, P < 0.001), whereas myocardial MRI values did not correlate at all with measurements derived from echocardiography. Regarding iron chelation treatment, patients receiving combined therapy with deferiprone and deferoxamine (DFO) significantly reduced myocardial iron overload during the 4‐yr study period, whilst patients in monotherapy with DFO showed a significant increase in LIC.