Combination iron chelation therapy with deferiprone and deferasirox in iron-overloaded patients with transfusion-dependent β-thalassemia major

There are few papers on the combination therapy of deferiprone (DFP) and deferasirox (DFX) in iron-overloaded patients with transfusion-dependent beta-thalassemia major (beta-TM). A total of 6 patients with beta-TM (5 males and 1 female) with a mean age of 23.8 +/- 5.8 years (ranging from 17 to 31) used this treatment regimen. The mean doses of DFP and DFX were 53.9 +/- 22.2 and 29.3 +/- 6.8 mg/kg/day, respectively. The duration of treatment was 11.5 +/- 4.6 months. Their serum ferritin levels were measured to be 2800 +/- 1900 and 3400 +/- 1600 ng/mL before and after treatment, respectively (p < 0.6). Their cardiac magnetic resonance imaging (MRI) T2* values were 16.69 +/- 15.35 vs 17.38 +/- 5.74 millisecond (ms) before and after treatment, respectively (p < 0.9). Although there was no significant difference between their cardiac MRI T2* values before and after treatment statistically, the values improved after combination therapy with DFP and DFX in most of the patients. Liver MRI T2 * values were changed from 2.12 +/- 0.98 to 3.03 +/- 1.51 ms after treatment (p < 0.01); Further, their liver T2* values and liver iron concentration (LIC) were improved after treatment. Our study found that cardiac MRI T2* values, liver MRI T2* values, and LIC were improved after combination therapy with DFP and DFX in beta-TM patients and that DFP and DFX combination therapy could be used to alleviate cardiac and liver iron loading.