Tazeen Anwar, Naila Yaqub, Zahoor Ahmad.
Efficacy and Safety of Intensive Desferal [Deferoxamine] Infusion in Thalassemia associated Iron Overload.
Ann Pak Inst Med Sci Jan ;9(4):195-7.

Objective: To see the efficacy and safety of intensive deferoxamine[DFO] infusion in blood transfusion associated iron overload in thalassemia major patients. Materials and Methods: This hospital based observational study was conducted at thalassemia centre, PIMS over a period of 3 years from January 2009 to Dec.2012.Those thalasemics having serum ferritin more than 3000ng/l inspite of taking defrasirox orally or subcutaneous deferoxamine were included. They received intravenous infusion of defroxamine[DFO] 50mg/kg over 24 hours for 10 consecutive days. Serum ferritin was measured at 0,6,12,18 months of study to see the efficacy of this regimen. Close monitoring was done to see any adverse effect during this infusion. Results: Serum ferritin ranged from 3050ng/l to 13600ng/l[mean 5939ng/l] at baseline for 48 patients enrolled in this study.Serum ferritin 6 month after intensive regimen ranged from 990ng/l to 13000ng/l][mean 4113ng/l].It was from 1079ng/l to 13000ng/l[mean 3769ng/l] and 1360ng/l to 7250ng/l [4132ng/l] at 12 and 18 months after this infusion respectively. Conclusion: In our study mean serum ferritin decreased from 5953ng/ml to 4119ng/ml[30%reduction] p value<.0001 at 6 month after this intensive regimen. This reduction was maintained at 12 month[mean3769ng/l] but after 18 month of this therapy mean serum ferritin increased to 4132ng/ml. we conclude that intensive intravenous regimen of defroxamine is effective and safe to decrease iron overload in those thalassemics who have high serum ferritin inspite of taking oral defrasirox in full dose or using s/c deferoxamine.

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