Combined iron chelation therapy Academic Article uri icon


MeSH Major

  • Chelation Therapy
  • Iron Chelating Agents
  • beta-Thalassemia


  • Patients with thalassemia major accumulate body iron over time as a consequence of continuous red blood cell transfusions which cause hepatic, endocrine, and cardiac complications. Despite the availability of three iron chelators, some patients fail to respond adequately to monotherapy with any of them. Combination therapy, consisting in the use of two chelators on the same day, has been introduced to increase the efficacy and to induce negative iron balance in patients with severe iron overload. Extensive long-term experience has shown that combined chelation with deferiprone and deferoxamine (DFO) rapidly reduces liver iron, serum ferritin, and myocardial siderosis, improves cardiac function, reverses and prevents endocrine complications, reduces cardiac mortality, and improves survival. Side effects, though significant, are manageable if properly monitored. Preliminary promising results have been obtained using combined chelation with deferasirox and DFO. As more drug combination regimes are evaluated, it should be possible to better tailor iron chelation to the needs of the patients, minimizing toxicity and maximizing efficacy throughout life.

publication date

  • August 2010



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1111/j.1749-6632.2010.05591.x

PubMed ID

  • 20712777

Additional Document Info

start page

  • 79

end page

  • 86


  • 1202