A Study of the Mechanisms and Sites of Action of Desferrioxamine in Thalassaemia Major

Bianco, I; B, Graziani; Lerone, Margherita; Congedo, P.; Clemente, G.F.; Ingrao, G.; Ciccone, Fabrizio; Nucci, Gianluca; Mandelli, F; Isacchi, G

doi:10.1159/000206565

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…3. The FO is slowly excreted in the urine and bile [1,12,16]. This excretion is progressive, slow and delayed as pointed out by Summers et al [21].…”

Section: Discussionmentioning

confidence: 99%

Studies of variations of subcutaneously infused desferrioxamine and iron movements in thalassaemia children

et al. 1989

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Desferrioxamine (DFO) plus ferrioxamine (FO) variations and alterations in plasma and urinary iron (Fe) levels were investigated in eight children with thalassaemia major during a 12-h s.c. DFO infusion at a dose of 40 mg/kg body weight. During the infusion, blood samples were regularly taken and total urine was also regularly collected in all patients. In the plasma, a mean DFO plus FO plateau level of 9 mg/l was reached after 4 h and remained steady in the subsequent 8 h. At 30 h the mean DFO plus FO concentration in plasma was still 4.5 mg/l. At 30 h, the urinary excretion ranged from 15% to 70% of the infused dose (mean: 42%). In plasma, the Fe concentration increased on average by 20% (range 10%-30%), remained steady during the DFO infusion, then returned to the basal level after 16-24 h. Urinary Fe excretion started early and still persisted 18 h after the infusion. The amount excreted at 30 h ranged from 5 to 27 mg (mean: 13.6 mg). This study emphasizes the delay in obtaining a DFO plus FO plateau in plasma, the important interindividual variations and the slow decrease of the drug after the end of the infusion. It points out the delay and the values of the urinary Fe excretion compared to the plasmatic and urinary drug variations.

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“…3. The FO is slowly excreted in the urine and bile [1,12,16]. This excretion is progressive, slow and delayed as pointed out by Summers et al [21].…”

Section: Discussionmentioning

confidence: 99%

Studies of variations of subcutaneously infused desferrioxamine and iron movements in thalassaemia children

et al. 1989

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“…Measurement of fecal iron excretion was not performed in the present study. The literature data are scarce and ranged from 10 to 50% of the urinary excretion with an intramuscular or subcutaneous DF dose of 500 mg or 20 mg/kg in 21 patients with iron overload (22)(23)(24)(25)(26)(27), and from 49 to 65% for DF administered intravenously to four iron-overloaded patients (27). Thus, to calculate iron balance, we used the average obtained from the extreme values of 10 to 50% total iron excreted into the feces.…”

Section: Methodsmentioning

confidence: 99%

Urinary iron excretion induced by intravenous infusion of deferoxamine in ß-thalassemia homozygous patients

Boturao-Neto

Marcopito

Zago

2002

Braz J Med Biol Res

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The purpose of the present study was to identify noninvasive methods to evaluate the severity of iron overload in transfusion-dependent ß-thalassemia and the efficiency of intensive intravenous therapy as an additional tool for the treatment of iron-overloaded patients. Iron overload was evaluated for 26 ß-thalassemia homozygous patients, and 14 of them were submitted to intensive chelation therapy with high doses of intravenous deferoxamine (DF). Patients were classified into six groups of increasing clinical severity and were divided into compliant and non-compliant patients depending on their adherence to chronic chelation treatment. Several methods were used as indicators of iron overload. Total gain of transfusion iron, plasma ferritin, and urinary iron excretion in response to 20 to 60 mg/day subcutaneous DF for 8 to 12 h daily are useful to identify iron overload; however, urinary iron excretion in response to 9 g intravenous DF over 24 h and the increase of urinary iron excretion induced by high doses of the chelator are more reliable to identify different degrees of iron overload because of their correlation with the clinical grades of secondary hemochromatosis and the significant differences observed between the groups of compliant and non-compliant patients. Finally, the use of 3-9 g intravenous DF for 6-12 days led to a urinary iron excretion corresponding to 4.1 to 22.4% of the annual transfusion iron gain. Therefore, continuous intravenous DF at high doses may be an additional treatment for these patients, as a complement to the regular subcutaneous infusion at home, but requires individual planning and close monitoring of adverse reactions.

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Deferoxamine-enhanced fecal losses of aluminum and iron in a patient undergoing continuous ambulatory peritoneal dialysis

McCarthy

Kurtz

Mussman

1987

The American Journal of Medicine

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A Study of the Mechanisms and Sites of Action of Desferrioxamine in Thalassaemia Major

Cited by 6 publications

References 4 publications

Studies of variations of subcutaneously infused desferrioxamine and iron movements in thalassaemia children

Studies of variations of subcutaneously infused desferrioxamine and iron movements in thalassaemia children

Urinary iron excretion induced by intravenous infusion of deferoxamine in ß-thalassemia homozygous patients

Deferoxamine-enhanced fecal losses of aluminum and iron in a patient undergoing continuous ambulatory peritoneal dialysis

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