A novel delivery system for continuous desferrioxamine infusion in transfusional iron overload

Abstract

Fifteen iron-overloaded thalassaemia major (TM) patients and two homozygous sickle cell patients (SCD) were treated continuously for 7d each week with the novel 48 h continuous subcutaneous (s.c.) desferrioxamine (DFX) delivery device (code C1083, Baxter) and 10 TM patients received the 24 h continuous intravenous (i.v.) DFX delivery device (code C1071). The 27 patients had previously received conventional s.c. DFX for 8-10h on 5 or more days each week. The serum non-transferrin bound iron (NTBI) levels fell significantly in both groups within 12h of commencing the continuous infusion. In the s.c. group the mean level fell from 4.2 to 2.0 mumol/l (P = 0.001), whereas in the i.v. group the mean level fell from 3.6 to 0.1 mumol/l (P = 0.006) the initial levels being measured 12h after stopping conventional s.c. DFX. After 4 weeks there was a significant fall in serum ferritin in both groups (P = 0.009). The new DFX delivery device is effective at removing toxicfree iron from plasma and reducing body iron. Moreover, it is preferred by patients with much improved compliance compared to the conventional s.c. DFX pump.

Continuous low-dose subcutaneous desferrioxamine (DFO) to prevent allergic manifestations in patients with iron overload

“…Our data show that continuous low-dose s.c. DFO infusion using the C 1083 infusor has been effective in reducing iron overload, as already shown by others [16], and in preventing allergic reactions. With this device we have transformed three noncompliant into highly compliant s.c. DFO patients.…”

Hemoglobin and Myoglobin Associated Oxidative Stress: from Molecular Mechanisms to Disease States

“…In conditions of non-iron overload, however, this toxicity is prevented by the presence of transferrin that sequesters the iron. It has also been shown that release of iron from Hb when these systems are exposed to H 2 O 2 is limited [59], leading to the complications arising from the excess iron [66][67][68]. α-Hydroxypyridinones are an orally active alternative to desferrioxamine in treatment of iron overload [69][70][71][72].…”

Value of sequential monitoring of left ventricular ejection fraction in the management of thalassemia major

“…In the early years of the study, maximal 12-hour infusions were possible through mechanical pumps (up to 60 mg/kg per day). After 1994, subcutaneous DFO was given through 24-hour disposable balloon infusers 22 at doses of 40 to 60 mg/kg per day up to 7 days a week. The third modality was continuous 24-hour intravenous infusion of DFO (100 mg/kg) diluted in 500 to 1000 mL normal saline and delivered though a peripheral vein on an inpatient basis for up to 1 week at a time to supplement ongoing subcutaneous treatment.…”