Four-year evaluation of myocardial and liver iron assessed prospectively with serial MRI scans in young patients with ?-thalassaemia major: comparison between different chelation regimens
- 1 January 2007
- journal article
- clinical trial
- Published by Wiley in European Journal of Haematology
- Vol. 78 (1), 52-57
- https://doi.org/10.1111/j.0902-4441.2006.t01-1-ejh3013.x
Abstract
This study was conducted in order to assess myocardial and liver iron concentrations (LICs) using serial magnetic resonance imaging (MRI) scans in patients with beta-thalassaemia major, over a 4-yr period, and consequently to compare the effectiveness of different chelation regimens. Fifty children and young adults with beta-thalassaemia major (27 boys and 23 girls) were recruited (mean age: 14.74 +/- 3.67 yr). All patients underwent detailed clinical examination, electrocardiography, echocardiography, myocardial and liver MRI at the beginning of the study, 2 and 4 yr after. Additionally, serum ferritin levels were regularly measured and data regarding LICs assessed by percutaneous liver biopsy were available in 26 patients. Both myocardial and liver MRI values showed a moderate inverse correlation with age (r = -0.379, P < 0.001 and r = -0.376, P < 0.001, respectively). Liver MRI was better correlated with serum ferritin concentrations (r = -0.342, P < 0.001) than myocardial MRI (r = -0.186, P = 0.011). Liver MRI values were highly correlated with LICs derived from percutaneous liver biopsy (r = -0.863, P < 0.001), whereas myocardial MRI values did not correlate at all with measurements derived from echocardiography. Regarding iron chelation treatment, patients receiving combined therapy with deferiprone and deferoxamine (DFO) significantly reduced myocardial iron overload during the 4-yr study period, whilst patients in monotherapy with DFO showed a significant increase in LIC.Keywords
This publication has 26 references indexed in Scilit:
- Correlative Study of Iron Accumulation in Liver, Myocardium, and Pituitary Assessed With MRI in Young Thalassemic PatientsJournal of Pediatric Hematology/Oncology, 2006
- Effective Combination Therapy of Deferiprone and deferoxamine for the Rapid Clearance of Excess Cardiac IRON and the Prevention of Heart Disease in Thalassemia. The Protocol of the International Committee on Oral ChelatorsHemoglobin, 2006
- A comparison of magnetic resonance imaging and cardiac biopsy in the evaluation of heart iron overload in patients with β‐thalassemia majorEuropean Journal of Haematology, 2005
- Myocardial iron loading in transfusion-dependent thalassemia and sickle cell diseaseBlood, 2004
- Evaluation of iron overloadBritish Journal of Haematology, 2004
- ThalassemiaHematology-American Society Hematology Education Program, 2004
- Iron Deficiency and OverloadHematology, 2003
- Secondary Iron OverloadHematology, 2001
- Underlying Causes and Long-Term Survival in Patients with Initially Unexplained CardiomyopathyThe New England Journal of Medicine, 2000
- Hepatic iron overload in thalassemic patients: Proposal and validation of an MRI method of assessmentPediatric Radiology, 1996