IMR Press / FBL / Volume 23 / Issue 6 / DOI: 10.2741/4634

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

Chelation protocols for the elimination and prevention of iron overload in thalassaemia

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1 Postgraduate Research Institute of Science, Technology, Environment and Medicine Limassol, Cyprus
Front. Biosci. (Landmark Ed) 2018, 23(6), 1082–1098; https://doi.org/10.2741/4634
Published: 1 January 2018
Abstract

Iron overload toxicity is the main cause of mortality and morbidity in thalassaemia patients. The complete elimination and prevention of iron overload is the main aim of chelation therapy, which can be achieved by chelation protocols that can effectively remove excess iron load and maintain body iron at normal levels. Deferiprone and selected combinations with deferoxamine can be designed, adjusted and used effectively for removing all excess stored iron and for maintaining normal iron stores (NIS) in different categories of thalassaemia patients. High doses of deferiprone (75-100 mg/kg/day) and deferoxamine (50-60 mg/kg, 1-7 days/week) combinations can be used for achieving and maintaining NIS in heavily iron loaded transfused patients. In contrast, deferiprone (75-100 mg/kg/day) can be used effectively and sometimes intermittently for maintaining NIS in non heavily transfused patients. Deferasirox can in particular be used in patients not tolerating deferoxamine and deferiprone. The design of tailored made personalised protocols using deferiprone and selected combinations with deferoxamine should be considered as optimum chelation therapies for the complete treatment and the prevention of iron overload in thalassaemia.

Keywords
Thalassaemia
Transfusion
Iron overload
Normalisation of iron stores
Maintenance of iron stores
Deferoxamine
Deferiprone
Deferasirox
Combination therapy
Review
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