Abstract :
Objectives: To study the effect of oral iron chelator on serum ferritin level in patients with thalassemia
major, we see the dose and frequency of oral iron chelator and its effect on serum ferritin and BT (Blood
transfusion) iron overload.
Material and Methods: Patients with thalassemia with 5-18 year of age are taken in our study. Total
numbers of patients taken are 50.1st Group is with BT iron overload of 0.2-0.3mg/kg/day is given oral
iron chelator in the dose 20mg/kg/day & serum ferritin should be overload of >0.3mg/kg/day is given oral iron chelator in the dose 30mg/kg/day & serum ferritin should
be >1500ng/ml. Oral iron chelator is given according to serum ferritin level which is done at frequent
intervals. Oral iron chelator is given as per serum ferritin level and maximum dose of oral iron chelator is
40 mg/kg/day. We study the dose of oral iron chelator, change in serum ferritin level and its effects on BT
iron overload.
Results: Number of patients with BT iron overload in the range of 0.2-0.3 mg/kg is n=25(50%) in 1st
Group. Number of patients with BT iron overload in the range of >0.3-0.4 mg/kg is n=15(30%) in 2nd
Group. Number of patients with BT iron overload is more than 0.4 is n=10 (20%) in 3rd group. Calculated
probability of average dose of oral iron chelator is 3rd group. There is significant decrease in serum ferritin level in 3 groups when we compare it with our
beginning level (calculated probability BT iron overload, but BT iron overload is depend on dose of oral iron chelator. Serum iron concentration
is also lowered as there is increase in dose of oral iron chelator.
Conclusions: In our study we can say that oral iron chelator which can reduce serum ferritin level
maximally was 30 mg/kg/day and showing very less side effects (BT iron overload taken for consideration
was 0.3-0.4mg/kg/day). Oral iron chelator should be given less than 30mg/kg/day in patients having less
BT frequency and less BT iron overload.
Keyword :
Thalassemia, Oral iron chelator, BT iron overload, Serum ferritin.