Blood, Vol. 95 No. 9 (May 1), 2000:
pp. 2776-2779
Safety and efficacy of subcutaneous bolus injection of
deferoxamine in adult patients with iron overload
Massimo Franchini,
Giorgio Gandini,
Marzia de
Gironcoli,
Aurora Vassanelli,
Caterina Borgna-Pignatti, and
Giuseppe Aprili
From the Servizio di Immunoematologia e Trasfusione, Azienda
Ospedaliera di Verona, Verona, Italy; and Dipartimento di Medicina
Clinica e Sperimentale, Sezione di Pediatria, Università di
Ferrara, Ferrara, Italy.
We compared 48-hour urinary iron excretion after a twice-daily
subcutaneous bolus injection of deferoxamine and after 12 hours of
subcutaneous continuous infusion of the drug in 27 patients with iron
overload (mean age, 55.7 years). In most patients, the iron overload
was due to multiple transfusions administered during chemotherapy or as
part of supportive care for a hematologic or oncologic disorder. One
patient had sickle cell anemia and 1 had hereditary hemochromatosis and
spherocytosis. Similar urinary iron excretion was observed with the 2 methods of administration; mean ± SD values were
6935.3 ± 3832.3 µg/48 hours with subcutaneous bolus injection and
6630.4 ± 3606.9 µg/48 hours with subcutaneous continuous infusion
(P = .3). Twenty-six patients (96.3%) chose to continue
therapy with bolus injection. The long-term efficacy of bolus injection
was evaluated by measuring the serum ferritin concentration at regular
intervals for a follow-up time of 20.1 ± 4.5 months. Ferritin
concentration decreased to below 1000 µg/L in 73% of the patients
and to below 500 µg/L in 42% and became normal in 26%. Best results
were obtained in patients who were no longer receiving blood
transfusions when chelation therapy was initiated. Three of 26 patients
(11.5%) had mild, transient side effects after bolus injection. Larger
prospective, randomized studies must be conducted before deferoxamine
bolus injection can be routinely recommended for patients with iron overload.
