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therapy

DESfERRIOXAMINE IN PATIENTS WITH TRANSFUSIONAL IRON OVERLOAD

.. . ·SC Infusion Increases lro_n Excretion More Than IM Injection Iron overload with cardiac toxicity is the main cause of death in patients with refractory anaemias treated with regular blood transfusions. Attempts are made to reduce the toxic effects with iron-chelating drugs- usually desferrioxamine. Continuous SC delivery of desferrioxamine produced substantially more urinary iron excretion than a single IM injection in I I patients with thalassaemia major and I with congenital sideroblastic anaemia who were being m1tintained on regular blood transfusions. 'rn 9 patients who received 7 SOmg of desferrioxamine IM before transfusion, total 48-hour urinary iron excretion ranged from 3. 3 to 40.3mg (mean 16.3mg)and from 3.3to 32.3mg (mean 11.9mg) in I 0 patients who received desferrioxamine by the sam~ route after transfusion. In the 9 patients studied before transfusion, continuous SC infusion of 7 SOmg over 24 hours gave a 61.5-135.8% increase in urinary iron excretion compared with IM injection. In the I 0 patients studied after transfusion the iron excretion with SC infusion was 18.9-213% greater than with IM injection·ofdesferrioxamine. 1500mg over 24 hours in 6 patients produced an even greater increase in iron excretion. A suitable small portable pump or a slow-release parenteral preparation is needed to determine the long-tenn effeets of continuous SC desferrioxamine infusion.

'Continuous administration of DF(desferrioxamine) may be valuable in preventing and, indeed, treating iron overload in anaemic patients receiving regular blood-'transfusions.'

HuSslliri, M.A.M. eta!.: Lancet 2: 1278 (II Dec 1976)

INPHARMA 24th December, 1976 p8