Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Effect of Combination Iron Chelating Agents on Reducing the Severity Grading of Heart and Liver Iron Overload in Β-Thalassemia Patients Publisher



Ghanavat M1 ; Varzaneh AF2 ; Reisi N3
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Pediatric, Assistant of Pediatrics, Imam Hussein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Iranian Journal of Pediatric Hematology and Oncology Published:2019


Abstract

Background: Deferasirox (DFX), Deferoxamine (DFO), and Deferiprone (DFP) are iron chelators that can be used in thalassemic patients with iron overload. Materials and Methods: This clinical trial was performed on 108 thalassemic patients who were randomly divided into group A (n=54) and B (n=54). Group A received combination of DFX and DFP, and group B received DFO and DFP for six months. Serum ferritin level was measured at the beginning of the study, 3, and 6 months after the treatment; The heart and liver iron deposition rates were also measured at the beginning of the study, and 6 months after the treatment in both groups and compared using Magnetic Resonance Imaging T2 plus (MRI T2*). Results: The mean age of patients in group A and B was 17.29±4.3 and 17.89±5.61 years old, respectively. Serum ferritin level significantly reduced after the treatment (Serum ferritin level at baseline, 3, and 6 months after the treatment in Group A: 2476.25±1289.32, 2089.62±1051.64 and 1290.22±724.78 ng/ml, respectively; in Group B: 2044.63±989.82, 1341.30±887.62 and 1229.41±701.22 ng/ml, respectively) (p<0.01, for both groups). MRI T2* heart and liver was also improved at the end of the study in both groups (p<0.01, for both groups). However, the combination of DFO/DFP significantly decreased severity grades of liver iron deposition in comparison to DFX/DFP regimen after six months (p<0.01). Conclusion: The results of the present study indicated that both combination therapies of DFO/DFP and DFX/DFP could improve heart and liver MRI T2*. However, DFO/DFP combination therapy was more effective in reducing the severity grades of liver iron deposition. © 2019. All Rights Reserved.
Related Docs
View other Related Docs
1. Comparison of Iron Chelation Effects of Deferoxamine, Deferasirox, and Combination of Deferoxamine and Deferiprone on Liver and Cardiac T2* Mri in Thalassemia Maior, Caspian Journal of Internal Medicine (2017)
2. T2-Weighted Cardiovascular Magnetic Resonance and Echocardiographic Arterial Elasticity Criteria for Monitoring Cardiac Siderosis in Patients With Beta-Thalassemia Major, Journal of Research in Medical Sciences (2022)
3. Therapeutic Effects of Deferoxamine and Silymarin Versus Deferoxamine Alone in Β-Thalassemia Major Based on Findings of Liver Mri, Journal of Research in Medical Sciences (2012)
4. The Correlation Between the Cardiac and Hepatic Iron-Overload in Patients With Thalassemia Major Who Received Multiple Transfusion, Journal of Isfahan Medical School (2010)
5. Evaluation of Iron Status by Serum Ferritin Level in Iranian Carriers of Beta Thalassemia Minor, International Journal for Vitamin and Nutrition Research (2008)
6. Efficacy and Safety of Iranian Made Deferasirox (Osveral®)In Iranian Major Thalassemic Patients With Transfusional Iron Overload: A One Year Prospective Multicentric Open-Label Non-Comparative Study, DARU, Journal of Pharmaceutical Sciences (2011)
7. Co-Administration of Silymarin and Deferoxamine Against Kidney, Liver and Heart Iron Deposition in Male Iron Overload Rat Model, International Journal of Preventive Medicine (2014)
8. Evaluating the Safety and Efficacy of Silymarin in Β-Thalassemia Patients: A Review, Hemoglobin (2015)
Experts (# of related papers)
View all Related Experts
Mohammad Reza Maracy (4)
Atoosa Adibi (3)
Other Related Docs
9. Chmmotv1 - Cardiac and Hepatic Multi-Echo (T2*) Mri Images and Clinical Dataset for Iron Overload on Thalassemia Patients, BMC Research Notes (2023)
10. Protective Role of Silymarin and Deferoxamine Against Iron Dextran-Induced Renal Iron Deposition in Male Rats, International Journal of Preventive Medicine (2013)
11. The Comparison of Efficacy of Original Brand Deferoxamine With Generic Iranian Made Deferoxamine in Urinary Iron Excretion in Patients With Thalassemia Major, Iranian Journal of Blood and Cancer (2018)
12. A Randomized Double-Blind, Placebo-Controlled Study of Therapeutic Effects of Silymarin in Β-Thalassemia Major Patients Receiving Desferrioxamine, European Journal of Haematology (2013)
13. Correlation of N-Terminal Pro-B-Type Natriuretic Peptide Levels and Cardiac Magnetic Resonance Imaging T2∗ in Patients With Β-Thalassaemia Major, Blood Transfusion (2016)
14. An Evaluation of Sensory Neural Hearing Loss in Thalassaemic Patients Treated With Desferrioxamine and Its Risk Factors, Journal of Research in Medical Sciences (2005)
15. Cardioprotection Potential of Some Hydroxypyridine Iron Chelators Against H2o2-Induced H9c2 Cell Injury, Turkiye Klinikleri Cardiovascular Sciences (2017)
16. Combined Therapy of Silymarin and Desferrioxamine in Patients With Β-Thalassemia Major: A Randomized Double-Blind Clinical Trial, Fundamental and Clinical Pharmacology (2009)
17. Beneficial Effects of the Treatment of Iron Deficiency on Clinical Condition, Left Ventricular Function, and Quality of Life in Patients With Chronic Heart Failure, Acta Biomedica (2018)
18. Magnetic Resonance Imaging Signal Reduction May Precede Volume Loss in the Pituitary Gland of Transfusion-Dependent Beta-Thalassemic Patients, Acta Radiologica (2010)
19. The Relation Between Body Iron Store and Ferritin, and Coronary Artery Disease, ARYA Atherosclerosis (2014)
20. Comparing Pituitary Mri Findings in Patients With Thalassemia With and Without Delayed Puberty, Journal of Isfahan Medical School (2011)
21. Effectiveness of Twice Weekly Iron Supplementation Compared With Daily Regimen in Reducing Anemia and Iron Deficiency During Pregnancy: A Randomized Trial in Iran, Journal of Research in Medical Sciences (2008)
22. Assessment of the Relationship Between Iron Overload Based on Cardiac T2* Mri and Fragmented Qrs in Beta-Thalassemia Major Patients, Shiraz E Medical Journal (2020)
23. Double-Faced Cell-Mediated Immunity in Β-Thalassemia Major: Stimulated Phenotype Versus Suppressed Activity, Annals of Hematology (2009)
24. Diagnostic Performance and Discriminative Value of the Serum Ferritin Level for Predicting Preterm Labor, Journal of Research in Medical Sciences (2012)
25. Cardiomyopathy in Thalassemia: Quick Review From Cellular Aspects to Diagnosis and Current Treatments, Lab Medicine (2020)
26. Biochemical Parameters of Iron Metabolism and Tg/Hdl-C Ratio in Patients With Coronary Artery Disease, Journal of Isfahan Medical School (2011)
27. Evaluation of the Prevalence and Determinants of Iron Deficiency Anemia in a Sample of Preschool-Aged Children in Isfahan City, Iran, Journal of Isfahan Medical School (2017)
28. Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron Plus Vitamin D Supplements: A Randomized Clinical Trial, Biological Trace Element Research (2021)
29. Hypercoagulopathy and Serum “Natural Antithrombotic Factors” in Beta-Thalassemia Major, Journal of Isfahan Medical School (2008)
30. Influence of Average Annual Mean Serum Ferritin Levels on Left Ventricular Function in Patients With Β Thalassemia, Acta Medica Iranica (2020)
31. Association of Body Mass Index and Serum Ferritin Level in Pediatrics With Beta-Thalassemia Major Disease, Iranian Journal of Pediatric Hematology and Oncology (2022)
32. Correlation Between Myocardial Iron Overload Detected by Cmrt2∗ and Left Ventricular Function Assessed by Tissue Doppler Imaging in Patients With Thalassemia Major, Journal of Cardiovascular Echography (2022)
33. Association Between Serum Ferritin and Goitre in Iranian School Children, Journal of Health, Population and Nutrition (2010)