SEARCH:   Advanced

Blood, 1 May 2006, Vol. 107, No. 9, pp. 3738-3744. Prepublished online as a Blood First Edition Paper on December 13, 2005; DOI 10.1182/blood-2005-07-2948. This Article Full Text (PDF) All Versions of this Article: 2005-07-2948v1 107/9/3738    most recent Alert me when this article is cited Alert me if a correction is posted 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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Pennell, D. J Articles by Galanello, R. Search for Related Content PubMed PubMed Citation Articles by Pennell, D. J Articles by Galanello, R. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 22, 2005 Accepted December 1, 2005 Randomized controlled trial of deferiprone or deferoxamine in beta-thalassemia major patients with asymptomatic myocardial siderosis Dudley J Pennell*, Vasili Berdoukas, Markissia Karagiorga, Vasili Ladis, Antonio Piga, Athanassios Aessopos, Efstathios D Gotsis, Mark A Tanner, Gill C Smith, Mark A Westwood, Beatrix Wonke, and Renzo Galanello National Heart and Lung Institute, Imperial College, London, United Kingdom; Royal Brompton Hospital, London, United Kingdom Aghia Sophia Children's Hospital, Athens, Greece Laikon Hospital, University of Athens, Athens, Greece Institute Euromedica-Encephalos, Athens, Greece Whittington Hospital, London, United Kingdom Royal Brompton Hospital, London, United Kingdom Ospedale Regionale per le Microcitemie, Cagliari, Italy * Corresponding author; email: d.pennell{at}ic.ac.uk. Most deaths in beta-thalassemia major result from cardiac complications due to iron overload. Differential effects on myocardial siderosis may exist between different chelators. A randomized controlled trial was performed in 61 patients previously maintained on subcutaneous deferoxamine. The primary endpoint was the change in myocardial siderosis (myocardial T2*) over 1 year in patients maintained on subcutaneous deferoxamine or those switched to oral deferiprone monotherapy. The dose of deferiprone was 92 mg/kg/day and deferoxamine was 43 mg/kg for 5.7 days/week. Compliance was 94 ± 5.3% and 93 ± 9.7% (p=0.81) respectively. The improvement in myocardial T2* was significantly greater for deferiprone than deferoxamine (27% vs 13%, p=0.023). Left ventricular ejection fraction increased significantly more in the deferiprone group (3.1% vs 0.3% absolute units, p=0.0034). The changes in liver iron (-0.93 vs -1.54mg/g dw, p=0.40), and serum ferritin (-181 vs -466ug/L, p=0.16) respectively were not significantly different between groups. The most frequent adverse events were transient gastrointestinal symptoms for deferiprone patients, and local reactions at the infusion site for deferoxamine. There were no episodes of agranulocytosis. Deferiprone monotherapy was significantly more effective than deferoxamine over 1 year in improving asymptomatic myocardial siderosis in beta-thalassemia major. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: P. Kirk, M. Roughton, J.B. Porter, J.M. Walker, M.A. Tanner, J. Patel, D. Wu, J. Taylor, M.A. Westwood, L.J. Anderson, et al. Cardiac T2* Magnetic Resonance for Prediction of Cardiac Complications in Thalassemia Major Circulation, November 17, 2009; 120(20): 1961 - 1968. [Abstract] [Full Text] [PDF] L. J. Noetzli, S. M. Carson, A. S. Nord, T. D. Coates, and J. C. Wood Longitudinal analysis of heart and liver iron in thalassemia major Blood, October 1, 2008; 112(7): 2973 - 2978. [Abstract] [Full Text] [PDF] B. Leonardi, R. Margossian, S. D. Colan, and A. J. Powell Relationship of magnetic resonance imaging estimation of myocardial iron to left ventricular systolic and diastolic function in thalassemia. J. Am. Coll. Cardiol. Img., September 1, 2008; 1(5): 572 - 578. [Abstract] [Full Text] [PDF] D. J. Pennell T2* magnetic resonance: iron and gold. J. Am. Coll. Cardiol. Img., September 1, 2008; 1(5): 579 - 581. [Full Text] [PDF] T. H. Marwick and M. Schwaiger The Future of Cardiovascular Imaging in the Diagnosis and Management of Heart Failure, Part 2: Clinical Applications Circ Cardiovasc Imaging, September 1, 2008; 1(2): 162 - 170. [Full Text] [PDF] E. Vichinsky Oral Iron Chelators and the Treatment of Iron Overload in Pediatric Patients With Chronic Anemia Pediatrics, June 1, 2008; 121(6): 1253 - 1256. [Full Text] [PDF] W.-Y. Au, W. W.-m. Lam, W. W.C. Chu, H.-L. Yuen, A. S.-C. Ling, R. C.-H. Li, H. M.-H. Chan, H. K.-K. Lee, M.-F. Law, H. S. Y. Liu, et al. A cross-sectional magnetic resonance imaging assessment of organ specific hemosiderosis in 180 thalassemia major patients in Hong Kong Haematologica, May 1, 2008; 93(5): 784 - 786. [Full Text] [PDF] E. Angelucci, G. Barosi, C. Camaschella, M. D. Cappellini, M. Cazzola, R. Galanello, M. Marchetti, A. Piga, and S. Tura Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders Haematologica, May 1, 2008; 93(5): 741 - 752. [Abstract] [Full Text] [PDF] W.-Y. Au, W. W.-M. Lam, W. Chu, S. Tam, W.-K. Wong, R. Liang, and S.-Y. Ha A T2* magnetic resonance imaging study of pancreatic iron overload in thalassemia major Haematologica, January 1, 2008; 93(1): 116 - 119. [Abstract] [Full Text] [PDF] Y. Aydinok, Z. Ulger, D. Nart, A. Terzi, N. Cetiner, G. Ellis, A. Zimmermann, and C. Manz A randomized controlled 1-year study of daily deferiprone plus twice weekly desferrioxamine compared with daily deferiprone monotherapy in patients with thalassemia major Haematologica, December 1, 2007; 92(12): 1599 - 1606. [Abstract] [Full Text] [PDF] N. Boddaert, K. H. Le Quan Sang, A. Rotig, A. Leroy-Willig, S. Gallet, F. Brunelle, D. Sidi, J.-C. Thalabard, A. Munnich, and Z. I. Cabantchik Selective iron chelation in Friedreich ataxia: biologic and clinical implications Blood, July 1, 2007; 110(1): 401 - 408. [Abstract] [Full Text] [PDF] J.-I. Henter and J. Karlen Fatal agranulocytosis after deferiprone therapy in a child with Diamond-Blackfan anemia Blood, June 15, 2007; 109(12): 5157 - 5159. [Abstract] [Full Text] [PDF] M.A. Tanner, R. Galanello, C. Dessi, G.C. Smith, M.A. Westwood, A. Agus, M. Roughton, R. Assomull, S.V. Nair, J.M. Walker, et al. A Randomized, Placebo-Controlled, Double-Blind Trial of the Effect of Combined Therapy With Deferoxamine and Deferiprone on Myocardial Iron in Thalassemia Major Using Cardiovascular Magnetic Resonance Circulation, April 10, 2007; 115(14): 1876 - 1884. [Abstract] [Full Text] [PDF] A. Aessopos, C. Fragodimitri, F. Karabatsos, A. Hatziliami, J. Yousef, A. Giakoumis, A. Dokou, E. D. Gotsis, V. Berdoukas, and M. Karagiorga Cardiac magnetic resonance imaging R2* assessments and analysis of historical parameters in patients with transfusion-dependent thalassemia Haematologica, January 1, 2007; 92(1): 131 - 132. [Abstract] [Full Text] [PDF] G. Fabio, F. Minonzio, P. Delbini, A. Bianchi, and M. D. Cappellini Reversal of cardiac complications by deferiprone and deferoxamine combination therapy in a patient affected by a severe type of juvenile hemochromatosis (JH) Blood, January 1, 2007; 109(1): 362 - 364. [Abstract] [Full Text] [PDF] H. Glickstein, R. B. El, G. Link, W. Breuer, A. M. Konijn, C. Hershko, H. Nick, and Z. I. Cabantchik Action of chelators in iron-loaded cardiac cells: accessibility to intracellular labile iron and functional consequences Blood, November 1, 2006; 108(9): 3195 - 3203. [Abstract] [Full Text] [PDF] A. R. Cohen New Advances in Iron Chelation Therapy Hematology, January 1, 2006; 2006(1): 42 - 47. [Abstract] [Full Text] [PDF]

	Copyright © 2005 by American Society of Hematology         Online ISSN: 1528-0020