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Blood, 15 January 2008, Vol. 111, No. 2, pp. 583-587. Prepublished online as a Blood First Edition Paper on October 19, 2007; DOI 10.1182/blood-2007-08-109306. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-08-109306v1 111/2/583    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Cohen, A. R. Articles by Porter, J. B. Search for Related Content PubMed PubMed Citation Articles by Cohen, A. R. Articles by Porter, J. B. Related Collections Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Effect of transfusional iron intake on response to chelation therapy in β-thalassemia major Alan R. Cohen1, Ekkehard Glimm2, and John B. Porter3 1 Children's Hospital of Philadelphia, PA; 2 Novartis Pharmaceuticals, Basel, Switzerland; and 3 University College London, London, United Kingdom The success of chelation therapy in controlling iron overload in patients with thalassemia major is highly variable and may partly depend on the rate of transfusional iron loading. Using data from the 1-year phase III study of deferasirox, including volumes of transfused red blood cells and changes in liver iron concentration (LIC) in 541 patients, the effect of iron loading on achieving neutral or negative iron balance was assessed in patients receiving different doses of deferasirox and the comparator deferoxamine. After dose adjustment, reductions in LIC after 1 year of deferasirox or deferoxamine therapy correlated with transfusional iron intake. At a deferasirox dose of 20 mg/kg per day, neutral or negative iron balance was achieved in 46% and 75% of patients with the highest and lowest transfusional iron intake, respectively; 30 mg/kg per day produced successful control of iron stores in 96% of patients with a low rate of transfusional iron intake. Splenectomized patients had lower transfusional iron intake and greater reductions in iron stores than patients with intact spleens. Transfusional iron intake should be monitored on an ongoing basis in thalassemia major patients, and the rate of transfusional iron loading should be considered when choosing the appropriate dose of an iron-chelating agent. This study is registered at http://clinicaltrials.gov as NCT00061750 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Oral iron chelation: new drug, old rules David G. Nathan Blood 2008 111: 483-484. [Full Text] [PDF]

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