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Iron chelation therapy in transfusion-dependent thalassemia patients: current strategies and future directions

Authors Saliba AN, Harb A, Taher A

Received 13 February 2015

Accepted for publication 20 March 2015

Published 17 June 2015 Volume 2015:6 Pages 197—209


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Martin H. Bluth

Antoine N Saliba, Afif R Harb, Ali T Taher

Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut, Beirut, Lebanon

Abstract: Transfusional iron overload is a major target in the care of patients with transfusion-dependent thalassemia (TDT) and other refractory anemias. Iron accumulates in the liver, heart, and endocrine organs leading to a wide array of complications. In this review, we summarize the characteristics of the approved iron chelators, deferoxamine, deferiprone, and deferasirox, and the evidence behind the use of each, as monotherapy or as part of combination therapy. We also review the different guidelines on iron chelation in TDT. This review also discusses future prospects and directions in the treatment of transfusional iron overload in TDT whether through innovation in chelation or other therapies, such as novel agents that improve transfusion dependence.

Keywords: thalassemia, transfusion-dependent thalassemia, iron overload, iron chelation therapy, transfusion

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