Abstract Ref Number = APCP930
Correlation of Deferiprone Dose with Iron Deposition in Liver and Heart in Thalassemia
Annisa Yulman,Teny Tjitra Sari
Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Background : Thalassemia major patients require regular packed red cell transfusion with approximate volume of 10-15 mL/kg every 3-4 weeks, which contains 1.1 mg iron per millilitre of pure PRC, that may lead to iron toxicity especially in heart and liver. Deferiprone is an oral chelating agent that has been widely used with typical daily dose of 75-99 mg/kg/day. We aim to see the correlation of deferiprone dose with iron deposition in heart and liver.
Material : A cross sectional study was conducted in Cipto Mangunkusumo Hospital. There were 199 thalassemia patients included and the correlation of deferiprone dose with the level of blood ferritin and iron deposition in heart and liver from MRI T2* examination was analysed. The level of iron deposition was categorized as normal, mild, moderate and severe.
Results : Dose of deferiprone were ranged from 27-121 mg/kg with median of 89 mg/kg, with ferritin levels ranged from 171-17724 ng/mL (r = - 0.27, p = 0.700). Patients with normal iron deposition in cardiac MRI T2* (n= 180) received deferiprone dose of 35-121 mg/kg with median dose of 90 mg/kg, while 2 patients with severe iron deposition had deferiprone dose of 38 mg/kg and 74 mg/kg (r = -0.32, p = 0.032). Patient with normal iron deposition in liver MRI T2* (n=20) received deferiprone dose of 50-100 mg/kg with median dose of 82.5 mg/kg, while in severe iron deposition (n=43) received 27-100 mg/kg with median dose of 87 mg/kg. (r = -0.47, p = 0.147).
Conclusions : There was negative and non-significant correlation between dose of deferiprone and blood ferritin level. There was no significant correlation between dose of deferiprone and iron deposition in liver. In contrast, we found significant correlation between deferiprone dose and heart iron deposition; the higher dose of deferiprone resulted in lower level of iron deposition in heart.
Keywords: Deferiprone Iron overload Thalassemia heart and liver