Deferasirox improves hematologic and hepatic function with effective reduction of serum ferritin and liver iron concentration in transfusional iron overload patients with myelodysplastic syndrome or aplastic anemia.

Abstract

BACKGROUND:

Transfusional iron overload and its consequences are challenges in chronically transfused patients with myelodysplastic syndromes (MDSs) or aplastic anemia (AA).

STUDY DESIGN AND METHODS:

This was a prospective, multicenter, open-label study to investigate the efficacy of deferasirox (DFX) by serial measurement of serum ferritin (S-ferritin) level, liver iron concentration (LIC) level using relaxation rates magnetic resonance imaging, and other laboratory variables in patients with MDS or AA.

RESULTS:

A total of 96 patients showing S-ferritin level of at least 1000 ng/mL received daily DFX for up to 1 year. At the end of the study, S-ferritin level was significantly decreased in MDS (p=0.02366) and AA (p=0.0009). LIC level was also significantly reduced by more than 6.7 mg Fe/g dry weight from baseline. Hemoglobin level and platelet counts were significantly increased from baseline (p=0.002 and p=0.025, respectively) for patients showing significant anemia or thrombocytopenia. Elevated alanine aminotransferase was also significantly decreased from baseline.

CONCLUSIONS:

This study shows that DFX is effective in reducing S-ferritin and LIC level in transfusional iron overload patients with MDS or AA and is well tolerated. In addition, positive effects in hematologic and hepatic function can be expected with DFX. Iron chelation treatment should be considered in transfused patients with MDS and AA when transfusion-related iron overload is documented.

• Authors: June-Won Cheong, Hyeoung-Joon Kim, Kyoo-Hyung Lee, Sung-Soo Yoon, Jae Hoon Lee, Hee-Sook Park, Ho Young Kim, Hyeok Shim, Chu-Myung Seong, Chul Soo Kim, Jooseop Chung, Myung Soo Hyun, Deog-Yeon Jo, Chul Won Jung, Sang Kyun Sohn, Hwi-Joong Yoon, Byung Soo Kim, Young-Don Joo, Chi-Young Park, Yoo Hong Min, Korean Society of Hematology Acute Myeloid Leukemia/Myelodysplastic Syndrome Working Party
• Journal: Transfusion (Transfusion) Vol. 54 Issue 6 Pg. 1542-51 (Jun 2014) ISSN: 1537-2995 [Electronic] United States
• PMID: 24313463 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
• Copyright: © 2013 AABB.

Chemical References

• Benzoates
• Triazoles
• Ferritins
• Iron
• Deferasirox

Topics

• Adult
• Aged
• Anemia, Aplastic (therapy)
• Benzoates (therapeutic use)
• Deferasirox
• Female
• Ferritins (blood)
• Humans
• Iron (metabolism)
• Iron Overload (drug therapy)
• Liver (drug effects, metabolism)
• Male
• Middle Aged
• Myelodysplastic Syndromes (therapy)
• Prospective Studies
• Transfusion Reaction
• Triazoles (therapeutic use)