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Effect of intravenous deferoxamine in multiply transfused patients

Korean Journal of Pediatrics 2007;50(12):1225-1230.
Published online December 15, 2007.
Effect of intravenous deferoxamine in multiply transfused patients
Sang Min Oh, Joon Won Kang, Sun Young Kim
Department of Pediatrics, The Chungnam National University College of Medicine, Daejeon, Korea
대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과
오상민, 강준원, 김선영
충남대학교 의과대학 소아과학교실
Correspondence: 
Sun Young Kim, Email: sunyoung@cnuh.co.kr
Abstract
Purpose
: Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions.
Methods
: From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients.
Results
: There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable.
Conclusion
: Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.
Key Words: Deferoxamine, Intravenous injection, Blood transfusions


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