Comparison of Magnetic Resonance Imaging T2 Results in Beta-Thalassemia Patients Treated by Deferasirox or Combination of Deferoxamine and Deferiprone

Abstract

Background: Iron extra load is an anticipated and lethal consequence of chronic blood transfusion in major beta-thalassemia patients; therefore it is necessary to use an efficient iron chelator drug to stimulate the evacuation of the surplus iron from the body. This trial was performed to compare myocardial and hepatic magnetic resonance imaging T2 (MRI T2*) results of beta-thalassemia patients treated by Deferasirox or combination of Deferoxamine and Deferiprone. Material and Methods: In this clinical trial, 44 patients who were on combination therapy with Deferiprone and Deferoxamine and complied with the inclusion criteria were randomized to either case (Deferasirox) or control (combined therapy) groups. Twenty-two patients in the case group received Deferasirox. For 22 patients in the control group, prior treatment with Deferiprone and Deferoxamine was continued. Myocardial and hepatic MRI T2* results were assessed before and after the study. Moreover, serum ferritin level (SFL) was evaluated every 3 months. Results: SFL at the start of the study did not differ significantly in two groups (2158.1± 1012.2 μg/L in the control group vs. 2145.5±1121.4 μg/L in the case group) (P=0.08). SFL at the end of the study did not differ significantly in two groups (2204.4±1143.5 μg/L in the control group vs. 2347.2±1236.6 μg/L in the case group), either (P=0.12). In each group, myocardial and hepatic MRI T2 at the start and at the end of the trial did not differ significantly (P>0.1). Conclusion: Myocardial and hepatic MRI T2*results were better in the control (combination therapy) group than those in the case (Deferasirox) group. Major beta-thalassemia patients replied to combined treatment better than Deferasirox.