Experience with Combination Therapy of Deferiprone and Desferrioxamine in β-Thalassemia Major Patients with Iron Overload at Maternity and Children Hospital, Al Madinah Al Munawarah, Saudi Arabia

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Describe our experience with combination therapy of Deferiprone (DFP) and Desferrioxamine (DFO) in treating β-Thalassemia Major patients with severe iron overload in Al Madinah Al Munawarah, Saudi Arabia and to determine any adverse events of treatment. Twenty eight patients with β-Thalassemia major between the ages of 8 - 27 (mean 15.5 ± 4.6 years SD) were enrolled into a prospective open label one year study from January 1 st 2006 to December 31 st 2006, at Al Madinah Maternity & Children's Hospital (Al Madinah Hereditary Blood Diseases Center). Participants were followed regularly at Al Madinah Hereditary Blood Diseases Center for at least 6 years prior to their enrolment in the study. The inclusion criteria were all patients who are transfusion dependent Thalassemia Major with an age of more than 8 years and serum ferretin levels > 3000 ng/L which were progressively increasing despite receiving chelating therapy with subcutaneous Desferrioxamine for at least 5 years prior to study. The doses used for Deferiprone was 75 mg/kg while the dose of Desferrioxamine was 40-50 mg/kg/day. Serum ferretin and other laboratory investigations were monitored every 3 weeks and adverse events of both drugs were assessed regularly along with patients’ compliance. There was no significant reduction of serum ferretin from baseline and by the end of the study period and no serious adverse events were observed. Deferiprone is a safe drug, however it did not reduce the serum ferretin from the base line, but it maintained the iron balance despite chronic transfusion in patients with β-Thalassemia major when used in combination with Desferrioxamine.