Effective new treatments of iron overload in thalassaemia using the ICOC combination therapy protocol of deferiprone (L1) and deferoxamine and of new chelating drugs

Abstract

An expert group of the International Committee on Oral Chelators (ICOC) has recommended a universally effective chelation combination protocol of oral deferiprone (L1) during the day (80-110 mg/kg /day) and subcutaneous deferoxamine (40-60 mg/kg) of a minimum of three nights per week for the rapid, safe and effective depletion of excess body iron in transfused iron loaded patients. Following the clearance of excess cardiac and liver iron load, deferiprone (L1) monotherapy at doses exceeding 80 mg/kg/day has been recommended for preventing the re-accumulation of excess iron in the heart and other organs. New chelators such as deferasirox may also be used in combinations with deferiprone (L1) and deferoxamine, especially in patients not tolerating the deferiprone (L1) / deferoxamine combination.