Experience with the oral iron chelator deferiprone in transfusion-dependent children.
Ceylon Med J
;
2002 Dec; 47(4): 119-21
Artigo
em Inglês
| IMSEAR
| ID: sea-48509
ABSTRACT
OBJECTIVE:
To establish efficacy and safety of deferiprone.DESIGN:
Prospective study.SETTING:
The Lady Ridgeway Hospital for Children, Colombo. PATIENTS Transfusion-dependent children in the age group 1 to 15 years. INTERVENTION Patients were given 75 mg/kg/day of deferiprone orally in divided doses. MEASUREMENTS Efficacy of deferiprone therapy was assessed by 4 to 6 monthly serum ferritin (SF) assays. Safety of therapy was assessed by 4-weekly white cell counts and serum alanine aminotransferase (ALT) levels. The Z-score was used to assess the significance of the difference between the mean initial and final SF level.RESULTS:
82 patients received deferiprone therapy for a mean duration of 30 +/- 14 months. Initial SF levels ranged from 1115 to 12,165 micrograms/l with a mean of 5156 +/- 2631 micrograms/l. Final SF levels ranged from 312 to 15,285 micrograms/l with a mean of 2809 +/- 2380 micrograms/l (Z score 5.99; p < 0.001). Two (2.4%) children developed agranulocytosis which reverted to normal on discontinuation of treatment. 41 (50%) developed arthropathy and in 17 this was severe enough to require discontinuation of therapy. Serum ALT levels were raised in 35 (43%) patients but reverted to pretreatment values or lower despite continuation of deferiprone therapy. There was one death in a 9-year old child who developed diabetes mellitus and heart failure despite deferiprone therapy for 3 years.CONCLUSIONS:
A final SF level < 2500 micrograms/l was achieved in 52% children. Severe arthropathy and agranulocytosis may necessitate permanent discontinuation of therapy.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Piridonas
/
Talassemia
/
Transfusão de Sangue
/
Feminino
/
Humanos
/
Masculino
/
Criança
/
Pré-Escolar
/
Quelantes de Ferro
/
Administração Oral
Tipo de estudo:
Estudo observacional
Idioma:
Inglês
Revista:
Ceylon Med J
Ano de publicação:
2002
Tipo de documento:
Artigo
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