Deferoxamine versus combined therapy for chelating liver, spleen and bone marrow iron in beta-thalassemic patients: a quantitative magnetic resonance imaging study

Hemoglobin
Eleni E DrakonakiApostolos Karantanas

Abstract

We used magnetic resonance imaging (MRI) to compare the effect of iron chelation on liver, spleen and bone marrow. We examined 21 beta-thalassemic patients undergoing deferoxamine (DFO) (9/21) or combined therapy [DFO and deferiprone (L1), 12/21] with two abdominal MRI studies using T1-w/Pd-w/T2*-wGRE and T1-wTSE sequences. Changes in serum ferritin (DF%), and liver, spleen and marrow to paraspinous muscles signal intensity ratios (SI) in T1-wTSE sequence were calculated as D%=[(2(nd)value-1(st) value)/1(st) value] x100%. Negative DF% and positive D(SI)% indicated reduction of iron. Although 17/21 (80.9%) patients demonstrated reduction in ferritin, only 8/21 (38%), 7/21 (33.3%) and 7/21 (33.3%) patients had decreased liver, spleen and marrow iron. Patients undergoing combined therapy showed significantly greater reduction (Student's t-test, p < 0.05) or less increase (t-test, p <0.05) in iron stores. Combined therapy is more effective than DFO for removing and preventing liver, spleen and bone marrow iron accumulation in beta-thalassemic patients. Magnetic resonance imaging is valuable for organ-specific monitoring of chelation therapy.

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Citations

Aug 5, 2014·Magnetic Resonance Imaging Clinics of North America·Shane A Wells
Nov 26, 2010·Magnetic Resonance Imaging Clinics of North America·Claude B Sirlin, Scott B Reeder
Aug 22, 2013·The Cochrane Database of Systematic Reviews·Sheila A FisherDavid J Roberts
Aug 24, 2013·The Cochrane Database of Systematic Reviews·Sheila A FisherDavid J Roberts
Feb 10, 2021·Skeletal Radiology·Maryam HajimoradiMajid Chalian

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