Comparison between Deferoxamine and Combined Therapy with Deferoxamine and Deferiprone in Iron Overloaded Thalassemia Patients

Background: Iron overload is the main cause of morbidity and mortality in patients with beta thalassemia major. Effective and convenient iron chelation remains one of the main targets of clinical management of thalassemia major. The combined treatment with deferoxamine and deferiprone could have an increased chelation efficacy and allow drug doses and toxicity to be reduced. Methods: Eighty patients with thalassemia major were randomized to receive one of the treatments: deferoxamine given in combination with deferiprone and deferoxamine alone. Changes in serum ferritin and any toxicity were determined. Results: After one year, the mean serum ferritin (±SD) in deferoxamine alone group decreased from 2945 (±591) ng/ml to 2,451 (±352) ng/ml (p<0.001). In the group treat with deferoxamine and deferiprone, a dramatical decline was noticed from 2986 (±612) ng/ml to 2,082 (±221) ng/ml (p<0.001). A significant improvement was observed after 6 months of combination therapy. The main side-effects were skin reactions (deferoxamine alone), nausea and arthralgia (combined therapy). Conclusion: Combination therapy is a practical and effective procedure to decrease severe iron overload in patients with beta thalassemia major.