J Korean Med Sci.  2013 Nov;28(11):1563-1572. 10.3346/jkms.2013.28.11.1563.

Korean Guideline for Iron Chelation Therapy in Transfusion-Induced Iron Overload

• Jang JH
• Lee JH
• Yoon SS
• Jo DY
• Kim HJ
• Chung J
• Lee JW

• KMID: 1777651
• DOI: http://doi.org/10.3346/jkms.2013.28.11.1563

Abstract

Many Korean patients with transfusion-induced iron overload experience serious clinical sequelae, including organ damage, and require lifelong chelation therapy. However, due to a lack of compliance and/or unavailability of an appropriate chelator, most patients have not been treated effectively. Deferasirox (DFX), a once-daily oral iron chelator for both adult and pediatric patients with transfusion-induced iron overload, is now available in Korea. The effectiveness of deferasirox in reducing or maintaining body iron has been demonstrated in many studies of patients with a variety of transfusion-induced anemias such as myelodysplastic syndromes, aplastic anemia, and other chronic anemias. The recommended initial daily dose of DFX is 20 mg/kg body weight, taken on an empty stomach at least 30 min before food and serum ferritin levels should be maintained below 1000 ng/mL. To optimize the management of transfusion-induced iron overload, the Korean Society of Hematology Aplastic Anemia Working Party (KSHAAWP) reviewed the general consensus on iron overload and the Korean data on the clinical benefits of iron chelation therapy, and developed a Korean guideline for the treatment of iron overload.

Keyword

Korean Guideline; Iron Overload; Deferasirox

MeSH Terms

Anemia, Aplastic/therapy
Benzoates/therapeutic use
Blood Transfusion/*adverse effects
Chelation Therapy/*methods
Humans
Iron Chelating Agents/*therapeutic use
Iron Overload/*therapy
Myelodysplastic Syndromes/therapy
Pyridones/therapeutic use
Republic of Korea
Triazoles/therapeutic use
Benzoates
Iron Chelating Agents
Pyridones
Triazoles

Figure

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  Fig. 1 Management of adverse events - Diarrhea (reported incidence: 15%).

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  Fig. 2 Management of adverse events - Abdominal pain (reported incidence: 6%).

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  Fig. 3 Management of adverse events - Nausea/vomiting (reported incidence: 22%, 8%).

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  Fig. 4 Management of renal adverse events (reported incidence: 25%).

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  Fig. 5 Management of skin adverse events (reported incidence: 11%).

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