TY - JOUR
T1 - Deferasirox, deferiprone and desferrioxamine treatment in thalassemia major patients: cardiac iron and function comparison determined by quantitative magnetic resonance imaging.
AU - Midiri, Massimo
AU - Prossomariti, Luciano
AU - Pepe, Alessia
AU - Malaventura, Cristina
AU - Quarta, Antonella
AU - Rossi, Giuseppe
AU - Lippi, Alma
AU - Meloni, Antonella
AU - Bisconte, Maria Grazia
AU - Missere, Massimiliano
AU - Pitrolo, Lorella
AU - Positano, Vincenzo
AU - Cianciulli, Paolo
AU - Filosa, Aldo
AU - Caruso, Vincenzo
AU - Capra, Marcello
AU - Putti, Maria Caterina
AU - Maggio, Aurelio
AU - Lombardi, Massimo
AU - Romeo, Maria Antonietta
PY - 2011
Y1 - 2011
N2 - BackgroundOral deferiprone was suggested to be more effective than subcutaneous desferrioxamine for removing heart iron. Oral once-daily chelator deferasirox has recently been made commercially available but its long-term efficacy on cardiac iron and function has not yet been established. Our study aimed to compare the effectiveness of deferasirox, deferiprone and desferrioxamine on myocardial and liver iron concentrations and bi-ventricular function in thalassemia major patients by means of quantitative magnetic resonance imaging.Design and MethodsFrom the first 550 thalassemia subjects enrolled in the Myocardial Iron Overload in Thalassemia network, we retrospectively selected thalassemia major patients who had been receiving one chelator alone for longer than one year. We identified three groups of patients: 24 treated with deferasirox, 42 treated with deferiprone and 89 treated with desferrioxamine. Myocardial iron concentrations were measured by T2* multislice multiecho technique. Biventricular function parameters were quantitatively evaluated by cine images. Liver iron concentrations were measured by T2* multiecho technique.ResultsThe global heart T2* value was significantly higher in the deferiprone (34+/-11ms) than in the deferasirox (21+/-12 ms) and the desferrioxamine groups (27+/-11 ms) (P=0.0001). We found higher left ventricular ejection fractions in the deferiprone and the desferrioxamine versus the deferasirox group (P=0.010). Liver iron concentration, measured as T2* signal, was significantly lower in the desferrioxamine versus the deferiprone and the deferasirox group (P=0.004).ConclusionsThe cohort of patients treated with oral deferiprone showed less myocardial iron burden and better global systolic ventricular function compared to the patients treated with oral deferasirox or subcutaneous desferrioxamine.
AB - BackgroundOral deferiprone was suggested to be more effective than subcutaneous desferrioxamine for removing heart iron. Oral once-daily chelator deferasirox has recently been made commercially available but its long-term efficacy on cardiac iron and function has not yet been established. Our study aimed to compare the effectiveness of deferasirox, deferiprone and desferrioxamine on myocardial and liver iron concentrations and bi-ventricular function in thalassemia major patients by means of quantitative magnetic resonance imaging.Design and MethodsFrom the first 550 thalassemia subjects enrolled in the Myocardial Iron Overload in Thalassemia network, we retrospectively selected thalassemia major patients who had been receiving one chelator alone for longer than one year. We identified three groups of patients: 24 treated with deferasirox, 42 treated with deferiprone and 89 treated with desferrioxamine. Myocardial iron concentrations were measured by T2* multislice multiecho technique. Biventricular function parameters were quantitatively evaluated by cine images. Liver iron concentrations were measured by T2* multiecho technique.ResultsThe global heart T2* value was significantly higher in the deferiprone (34+/-11ms) than in the deferasirox (21+/-12 ms) and the desferrioxamine groups (27+/-11 ms) (P=0.0001). We found higher left ventricular ejection fractions in the deferiprone and the desferrioxamine versus the deferasirox group (P=0.010). Liver iron concentration, measured as T2* signal, was significantly lower in the desferrioxamine versus the deferiprone and the deferasirox group (P=0.004).ConclusionsThe cohort of patients treated with oral deferiprone showed less myocardial iron burden and better global systolic ventricular function compared to the patients treated with oral deferasirox or subcutaneous desferrioxamine.
UR - http://hdl.handle.net/10447/103300
M3 - Article
VL - 96
SP - 41
EP - 47
JO - Haematologica
JF - Haematologica
SN - 0390-6078
ER -