Iron Overload and Chelation Therapy (4)

Chelation should begin one year after the start of chronic transfusions if a biopsy records a hepatic (liver) iron of higher than 3.2 mg/g dry weight. A baseline assessment of height and a spinal X-ray should be taken to monitor growth, and the daily dose of Desferal should not exceed 35 mg/kg dry weight during the first three years. After that, dose should not exceed 50 mg/kg.
Vitamin C is a supplement patients can take to help Desferal do its job. Supplements of 100-200 mg should be taken concurrent with Desferal use, for example 1/2 hour after the start of one's daily therapy. A word of caution: excessive vitamin C can exacerbate existing heart and liver problems by increasing the amount of iron circulating in the blood.

One of the most difficult problems associated with Desferal use is compliance. Nightly infusions of the medicine can be emotionally taxing and frustrating, especially for a patient entering their teen years. The effects of Desferal are not immediately felt, nor are the effects of iron overload, so teens often stop therapy for long periods of time. It is important to develop mentor programs and peer support groups early on to encourage good habits and regular use of Desferal. Only with consistent use of desferrioxamine can the damaging effects of iron overload be averted. Read more about Desferal in the next section. <back>

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To learn more about Iron Overload, including treatment recommendations and systems effected by iron-overload, please see pages 7-11 of our Standard of Care Guidelines.