Discussion Forums > Thalassemia Major

Ferritin level gone up

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§ãJ¡Ð ساجد:
Hi Mr. Tariq,

Desferal is injection (ideally) given slowly by infusion pump in the sub-cutaneous layer under the skin. While Kelfer (available as Ferinil in Pakistan) are the oral tablets.

Desferal has been used for many years and is the most commonly used chelator while Kelfer is relatively new and is used under regular supervision of blood counts.

Both are well reputed and the optimum result comes by using the combination of both as Desf. is known to remove Iron better from the liver while Kelfer from the heart.

Your child is small too. I suggest you ask your doctor about the proper time and S.F levels before starting chelation.

mrtariqkhan:
Thanks   :thumbsup

Ambika:
Dear all

Thank very much for your reply

Please tell me one more thing chelation is a painful procedure or not. if once chelation has been started how often it has to be used and what are its after effect.

regards
Rupali

§ãJ¡Ð ساجد:
Hi Rupali,

It depends which method you want to follow. Like I said Desferal is an injection; (ideally) given slowly by infusion pump in the sub-cutaneous (sub-Q) layer under the skin but it can also be given via the I.V drip. However, the slow sub-Q infusion is more efficient.

Kelfer and Exjade are the oral tablets.

Therefore, the oral tablets are more compliant and preferred if you want to avoid pain.
Chelation is life long until there is a permanent treatment of blood transfusion because it is the chelation that removes the excess Iron that comes with the blood.

As for the side effects, every drug has some in some cases. It is not necessary that everyone will have to face the side effects. Most of the time it is just a mild one and can be cured by lowering the dose. You should not be worried about them :) I will list the rare serious ones just for your knowledge but remember it is not necessary that they will happen to everyone.

Desferal is known to effect visual and audio senses if given in large doses in rare cases.
Kelfer is known to decrease the levels of zinc, white blood cells and platelet in some cases so they are monitored with it's use.
Exjade causes temporary mild rash and upset stomach in some people and increases Serum Creatinine in patients with renal issues.

Again, these are very rare and are listed just in case if there is an allergy issues with them for some patient. Even common pain killers have side effects mentioned so these are not to be alarmed about.

Canadian_Family:
Mrtariqkhan,

In my opinion it is the right time that you should start the chelation therapy for your daughter, I am weighing in following information you have provided:

1. Your child has had 17 transfusions so far (Chelation should start after 10-12 transfusions).
2. Your child is almost 2 years (Chelation begins at the age of two years).
3. Your child has a ferritin of 979 (This is high as per her age, please note for a normal person the ferritin levels are much less, if I remember correctly it is around 150-200).

You don't want to wait until it gets worse and now is the right time. I am not debating which chelator you should use, that is between you and your doctor but the point is to start the chelation right away.

Thanks

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