Patients Received Iron Chelation Therapy Research Articles

Comparison of the effects of deferasirox, deferiprone, and deferoxamine on the growth and virulence of Vibrio vulnificus

Since deferoxamine (DFO), a standard iron-chelating agent that is widely used in patients with iron overload such as hemochromatosis or thalassemia, is a kind of hydroxamine siderophore of Streptomyces species, it can accelerate the in vitro growth of ferophilic organisms such as Vibrio vulnificus, Yersinia enterocolitica, and Mucorales. We compared the effects of the two oral iron chelators, deferiprone (DFP) and deferasirox (DFS), on the growth and virulence of V. vulnificus with that of the parenteral iron-chelating drug DFO used to treat patients with iron overload. When V. vulnificus ATCC 27562 was grown in iron-poor liquid medium with α,α′-dipryridyl, addition of DFO promoted its growth, whereas DFP and DFS did not. Only DFP and DFS showed growth inhibitory effect by chelating iron and causing iron deprivation. Similarly, on iron-poor agar plates, various clinical V. vulnificus strains were only able to grow around filter paper disks impregnated with DFO. Our in vitro study data showed that DFS or DFP has more potential clinical application for preventing V. vulnificus infection in patients receiving iron chelation therapy. When patients with iron overload need iron chelation therapy, especially in a population at high risk for V. vulnificus in its endemic season, DFS or DFP may be safely used rather than DFO.

Marrow proliferation as a cause of hearing loss in beta-thalassaemia major

The aim of this report was to highlight the fact that hearing loss in thalassaemia patients can be related to marrow expansion affecting the ossicles, resulting in a conductive loss. A six-year-old boy with transfusion-dependent beta-thalassaemia developed a unilateral hearing loss shortly after commencing desferrioxamine therapy. Ototoxicity was assumed, but the deficit was later found to be of a conductive nature, due to marrow proliferation within the ossicular chain as a consequence of the disease process--a phenomenon previously unreported in the literature. It is important to elucidate the precise nature of new onset hearing loss in patients receiving iron chelation therapy, in order to avoid unnecessary cessation of much needed medication, on the assumption of ototoxicity.

25 Improved survival in myelodysplastic syndromes patients receiving iron chelation therapy

25 Improved survival in myelodysplastic syndromes patients receiving iron chelation therapy