Thalassemia Patients and Friends

Discussion Forums => Iron Chelation Corner => Topic started by: Eponine on April 15, 2006, 08:28:50 AM

Title: Complications in combination treamtment
Post by: Eponine on April 15, 2006, 08:28:50 AM

Ferriprox's main purpose is to chelate iron from the heart. I've heard that complications from Ferriprox is might be because there is nothing to chelate from the heart. Anyone heard about this? Is this the reason why I had agranulocytosis that bad? My agranulocytosis happened exactly a year ago, Apr - May 05. When I did my MRI T2* scan in Dec 05, it showed mild iron overload in my heart.
I'm quite confused. Any relations? Any one any comments?

Title: Re: Complications in combination treamtment
Post by: Andy Battaglia on April 15, 2006, 05:42:23 PM

Deferiprone (L1) has been shown to remove iron from the heart more efficiently than desferal, but that is not its only purpose. L1 is an excellent iron chelator in general and does perform superior to desferal in studies of long term heart health. However this not not mean that its main purpose is just to remove iron from the heart. It is meant to remove iron from all organs and tissues in the body.

The mechanism of why L1 causes neutropenia in no more than 6-8% of users and the far more serious agranulocytosis (found in less than 1% of users)  is not known.
From Cipla's (the manufacturer of Kelfer) site,

Quote

Due to the unknown mechanism of deferiprone-induced neutropenia, patients should not take medicinal products known to be associated with neutropenia or those that can cause agranulocytosis.

However, it has been observed that the problem is more prevalent in patients who still have their spleen. This might suggest a reaction in the immune system, rather than any relation to ferritin levels in the heart.

Eponine, you fall into that unlucky less-than-1% category. While patients who develop mild neutropenia may eventually be allowed to resume L1, patients that develop the more serious agranulocytosis, as you did, are not allowed to resume L1 therapy.

I would like to know if there are any sources you know of that suggest that agranulocytosis with L1 may be related to iron levels in the heart.

Title: Re: Complications in combination treamtment
Post by: Eponine on April 22, 2006, 04:35:27 PM

No... no sources. Just from my own deduction. From putting the info I have read and spending too much time thinking and trying to analyse it.  :biggrin