Assessment of the effect of combination therapy with deferiprone and desferrioxamine on cardiac complications in major thalassemia

ABSTRACT

Cardiac complications in major thalassemia are the most debilitating problem among them. Iron chelating with desferrioxamine, may be difficult or inadequate. The aim of this research is to evaluate the effect of combination therapy with the two drugs "deferiprone and desferrioxamine" on cardiac complications in major thalassemia. In a clinical trial study [before and after], 47 [24 men and 23 women] patients with major thalassemia referred to Booali research center, 10 to 35 years old, all of whom were undertaken combination therapy with deferiprone and desferrioxamine, enrolled in this study. Echocardiography was performed for all patients before and after at least 6 months of combination therapy. Echocardiographic systolic and diastolic function indices including LVEF, EPSS, CI and E/A, EF slope and MPI, as well as presence of arrhythmia were obtained. The data were analyzed by paired T Test and Pearson correlation. There were significant changes in ferritin, systolic function and MPI, indicating statistically significant improvement. Ferritin decreased to 3306 +/- 1347ng/ml from 4489 +/- 1607ng/ml [p=0.000]. LVEF increased to 69.7 +/- 2.6% from 67.6 +/- 3.9% [p=0.04]. EPSS decreased to 2.9 +/- 1.3mm from 3.9 +/- 2.1mm [p=0.004]. Cardiac Index increased to 3.6 +/- 0.18 from 3.5 +/- 0.3 [p=0.02]. MPI decreased to 0.33 +/- 0.05 from 0.37 +/- 0.06 [p=0.03]. Arrhythmia and diastolic function were also slightly improved which were statistically nonsignificant. The results showed that combination therapy with the two drugs deferiprone and desferrioxamine led to decrease ferritin level and improve systolic function in patients with major thalassemia