Strategies for Using Iron Chelation Therapy

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If a patient has received over 10 transfusions and has a ferritin level of >1000 it may be necessary to institute iron chelation therapy (ICT), believes Azra Raza, MD. Patients on ICT should be monitored every 2 to 3 months until the ferritin level goes below 500. At that time, ICT can be discontinued, with continued ferritin level monitoring every 2 to 3 months, Raza notes. If ferritin once again surpasses 1000, ICT can be reinstituted.

Raza stresses that the treating hematologist must also be convinced of the need for ICT in chronically transfused patients, and must advise their patients of this therapy. These treatments are necessary, since chronic iron overload can be a serious condition, specifically in patients with myelodysplastic syndromes. To simplify the administration of ICT, the FDA approved an oral formulation of deferasirox as a treatment for patients with chronic iron overload on March 30, 2015. The new formulation is a once-daily tablet.