López-Hernández MA, Romero-Rodelo H, Alvarado-Ibarra M

Language: Spanish
References: 16
Page: 262-270
PDF size: 456.26 Kb.

ABSTRACT

Background: Patients with acute leukemia and intensive chemotherapy treatment have a high transfusion requirement, that’s why they develop iron overload and hemochromatosis. This is added to the toxicity caused by chemotherapy. So, the intention to decrease these side effects arise.
Objective: To evaluate the effectiveness of deferasirox in lowering serum ferritin and serum transaminases in patients with acute leukemia who developed iron overload secondary to transfusions.
Patients and method: An experimental, prospective, longitudinal, nonrandomized study that included patients older than 15 years, diagnosed with acute leukemia and managed with a program of intensive chemotherapy who developed elevated transaminase AST + ALT ›90 U/L in serum ferritin ›1,000 ng/mL.
Results: A total of 32 patients was include from November 2010 to December 2015, all included in deferasirox treatment according to the inclusion criteria, 23 (72%) patients with acute lymphocytic leukemia, 6 (19%) patients with acute myeloid leukemia and 3 (9%) cases with ambiguous lineage. The initial and final average were respectively AST 69 U/L and 42 U/L, ALT 132 U/L and 65 U/L, AST + ALT 203 U/L and 197 U/L, 3,552 ng ferritin/mL and 1,757 U/L, DHL 254 U/L and 197 U/L with p ‹0.0007.
Conclusions: The high transfusion requirement in these patients also impacts on the toxicity of chemotherapy plus the amount of iron contained in transfused RBCs and the ability to excrete it of the organism. Deferasirox in these patients demonstrated efficacy in reducing the numbers of serum transaminases in patients with iron overload. The standard dose that should be administered for better efficacy with deferasirox is 30 mg/kg/day and most patients require up to a year or more of treatment to normalize serum ferritin.

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