Chelation in Thalassemia: Improved Status Over a Decade

Kushagra Taneja; Chandrika  Verma; Amita  Mahajan

Kushagra Taneja Department of Pediatric Hematology Oncology, Indraprastha Apollo Hospital, New Delhi, India
Chandrika Verma Department of Pediatric Hematology Oncology, Indraprastha Apollo Hospital, New Delhi, India
Amita Mahajan Department of Pediatric Hematology Oncology, Indraprastha Apollo Hospital, New Delhi, India

Keywords: Chelati on, Deferasirox, Iron Overload, Thalassemia

Abstract

Optimal chelation of iron overload is a major determinant of both the life span and health related quality of life in patients with transfusion dependent Thalassemia (TDT). With the introduction of Deferasirox (DFX) in India in 2008, it was hoped that once daily oral dosing, superior efficacy, favorable safety profile and availability of generics would lead to improved compliance and better control of iron overload. This was favored in our earlier study of 36 months duration (2011-2013) published in 2013. In this brief communication, we present the trend of iron overload status in our cohort over a decade duration. Analysis of 85 TDT patients on deferasirox alone or on combination chelation was done. Mean age of the cohort was 15 years. Mean/ median S. Ferritin values observed in 2011 and 2021 were 3042/ 2271 ng/ml and 1065/ 969 ng/ml respectively showing a significant decline in the iron overload. This was also reflected in as T2* MRI values showing evidence of moderate to severe iron overload in liver/ heart in 7%/ 2.3% respectively. No severe chelation related toxicity was noted. Motivating patients for continued compliance as this cohort becomes older is the biggest challenge.

Keywords: chelation, deferasirox, iron overload, transfusion dependent Thalassemia

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