Effect of combination therapy of hydroxyurea with <scp>l</scp>‐carnitine and magnesium chloride on hematologic parameters and cardiac function of patients with β‐thalassemia intermedia

Karimi, Mehran; Mohammadi, Faranak; Behmanesh, Farzane; Samani, Siamak; Borzouee, Mohammad; Amoozgar, Hamid; Haghpanah, Sezaneh

doi:10.1111/j.1600-0609.2009.01356.x

Cited by 23 publications

(14 citation statements)

References 39 publications

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“…Magnesium has demonstrated beneficial effects on hematological parameters in the present study and other work through its powerful antioxidant properties [50]. Indeed, magnesium reduces the load of free radicals and has potency in inhibiting platelet aggregation [51] which gives this oligo-element a powerful protective effect against the blood toxicity of CCl 4 .…”

Section: Discussionsupporting

confidence: 55%

“…Indeed, magnesium reduces the load of free radicals and has potency in inhibiting platelet aggregation [51] which gives this oligo-element a powerful protective effect against the blood toxicity of CCl 4 . Magnesium also has the power to protect blood from vanadate toxicity [12] and stabilize damaged red blood cell membranes [50]. In mouse, oral magnesium supplementation was found to increase hemoglobin levels and to reduce erythrocyte dehydration [52].…”

Section: Discussionmentioning

confidence: 99%

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Effects of MgCl2 supplementation on blood parameters and kidney injury of rats exposed to CCl4

et al. 2016

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The purpose of this study was to evaluate the beneficial effects of magnesium (Mg) supplementation upon carbon tetrachloride (CCl4) toxicity. Our study was carried out on 24 Wistar male rats divided into 4 batches. During a 6 week period, one group served as a control, two groups received Mg (after 4 weeks one of these groups was then treated with CCl4), and a final group was treated with CCl4 only. Under our experimental conditions, CCl4 poisoning resulted in oxidative stress indicated by a significant increase in lipid peroxidation level in renal tissues. The blood levels of creatinine and urea increased while the blood level of uric acid and proteins decreased. CCl4 also induced an increase in superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity in kidneys, in the number of red blood cells (RBC), and in hemoglobin content (Hb) and mean cell hemoglobin concentration (MCHC). However, white blood cell count (WBC), platelet count (Pl) and catalase activity (CAT) all decreased significantly. Treatment with Mg was found to alleviate most of CCl4-induced damage by decreasing lipid peroxidation and by correcting changed hematological parameters, and catalase, glutathione peroxidase and superoxide-dismutase activities. The results provide strong evidence that Mg supplementation is beneficial in protecting the kidneys from CCl4 toxicity.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Effects of MgCl2 supplementation on blood parameters and kidney injury of rats exposed to CCl4

et al. 2016

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“…A beneficial role in patients with pulmonary hypertension was suggested, especially upon combination with the antioxidant L-carnitine, although these findings primarily relied on echocardiographic findings. 66,99,100 In smaller studies, hydroxyurea therapy was also associated with improvements in endocrine function, 80 leg ulcers, 101 and extramedullary hemtopoietic tumors. 102 These findings are further confirmed through a 2010 cross-sectional study of 584 b-thalassemia intermedia patients from the Middle East and Italy, where hydroxyurea therapy was associated with reduced adjusted odds of extramedullary hemtopoietic tumors (0.52, 95% CI, 0.30-0.91), pulmonary hypertension (0.42, 95% CI, 0.20-0.90), leg ulcers (0.10, 95% CI, 0.02-0.43), hypothyroidism (0.05, 95% CI, 0.01-0.45), and osteoporosis (0.02, 95% CI, 0.01-0.09).…”

Section: Other Clinical Outcomesmentioning

confidence: 99%

Clinical experience with fetal hemoglobin induction therapy in patients with β-thalassemia

Musallam

Taher

Cappellini

et al. 2013

Blood

176

139

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Recent molecular studies of fetal hemoglobin (HbF) regulation have reinvigorated the field and shown promise for the development of clinical HbF inducers to be used in patients with β-thalassemia and sickle cell disease. However, while numerous promising inducers of HbF have been studied in the past in β-thalassemia patient populations, with limited success in some cases, no universally effective agents have been found. Here we examine the clinical studies of such inducers in an attempt to systematically review the field. We examine trials of agents, including 5-azacytidine, hydroxyurea, and short-chain fatty acids. This review highlights the heterogeneity of clinical studies done on these agents, including both the patient populations examined and the study end points. By examining the published studies of these agents, we hope to provide a resource that will be valuable for the design of future studies of HbF inducers in β-thalassemia patient populations.

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“…In patients who were not transfused, the Hb concentration increased. The same Iranian group more recently showed that the combination of hydroxyurea with L-carnitine or magnesium could be more effective in improving haematologic parameters and cardiac status in patients with TI than hydroxyurea alone (Karimi et al, 2010). However, whether hydroxycarbamide therapy can prevent rather than treat cardiac complication including PHT is not yet evaluated.…”

Section: Modulation Of Fetal Haemoglobin Productionmentioning

confidence: 99%

Optimal management of β thalassaemia intermedia

et al. 2011

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SummaryOur understanding of the molecular and pathophysiological mechanisms underlying the disease process in patients with b thalassaemia intermedia (TI) has substantially increased over the past decade. The hallmark of disease process in patients with TI includes ineffective erythropoiesis, chronic haemolytic anaemia, and iron overload. There are a number of options currently available for managing patients with TI including splenectomy, transfusion therapy, iron chelation therapy, modulation of fetal haemoglobin production, and several other agents targeting specific clinical complications. Limited studies assessed the efficacy and safety of these modalities; hence, there are currently no clear guidelines for managing patients with TI. Until solid evidence-based guidelines are available, individualised treatment should be entertained.

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Effect of combination therapy of hydroxyurea with l‐carnitine and magnesium chloride on hematologic parameters and cardiac function of patients with β‐thalassemia intermedia

Abstract: Combination of hydroxyurea with l-carnitine or magnesium could be more effective in improving hematologic parameters and cardiac status in patients with beta-thalassemia intermedia than hydroxyurea alone.

Cited by 23 publications

References 39 publications

Effects of MgCl2 supplementation on blood parameters and kidney injury of rats exposed to CCl4

Effects of MgCl2 supplementation on blood parameters and kidney injury of rats exposed to CCl4

Clinical experience with fetal hemoglobin induction therapy in patients with β-thalassemia

Optimal management of β thalassaemia intermedia

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