Chelation treatment in sickle-cell-anaemia: much ado about nothing?

Angela Vitrano, Gaetano Lucania, Gaetano Lucania, Aldo Filosa, Aurelio Maggio

Risultato della ricerca: Articlepeer review

22 Citazioni (Scopus)

Abstract

Blood transfusions may prevent and treat serious complications related to sickle-cell disease (SCD) when performedaccording to specific guidelines. However, blood transfusionrequirements in SCD inevitably lead to increased body ironburden. An adequate chelation treatment may preventcomplications and reduce morbidity and mortality. Thisreview evaluates the effectiveness, safety and costs of chelationtreatment. The included trials were examined according to therecommendations of the American College of Cardiology(ACC) and the American Heart Association (AHA). Overall,14 trials and a total of 502 patients with SCD were included inthis review. Deferoxamine alone (s.c. or i.v.), deferiprone aloneor versus deferoxamine, deferasirox versus deferoxamine andcombined treatment with deferoxamine plus deferiprone wereincluded and evaluated in the analysis. Only two randomizedclinical trials have been reported. The results of this analysissuggest that use of chelation treatment in SCD to date has beenbased on little efficacy and safety evidence, although it is widelyrecommended and practised. The cost/benefit ratio has notbeen fully explored. Further research with larger randomizedclinical trials needs to be performed.
Lingua originaleEnglish
pagine (da-a)545-555
Numero di pagine11
RivistaBritish Journal of Haematology
Volume154
Stato di pubblicazionePublished - 2011

All Science Journal Classification (ASJC) codes

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