Publication: Current approach to iron chelation in children
Issued Date
2014-01-01
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ISSN
13652141
00071048
00071048
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2-s2.0-84901694795
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Mahidol University
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SCOPUS
Bibliographic Citation
British Journal of Haematology. Vol.165, No.6 (2014), 745-755
Suggested Citation
Yesim Aydinok, Antonis Kattamis, Vip Viprakasit Current approach to iron chelation in children. British Journal of Haematology. Vol.165, No.6 (2014), 745-755. doi:10.1111/bjh.12825 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34782
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Title
Current approach to iron chelation in children
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Abstract
Transfusion-dependent children, mostly with thalassaemia major, but also and occasionally to a more significant degree, with inherited bone marrow failures, can develop severe iron overload in early life. Moreover, chronic conditions associated with ineffective erythropoiesis, such as non-transfusion-dependent thalassaemia (NTDT), may lead to iron overload through increased gut absorption of iron starting in childhood. Currently, the goal of iron chelation has shifted from treating iron overload to preventing iron accumulation and iron-induced end-organ complications, in order to achieve a normal pattern of complication-free survival and of quality of life. New chelation options increase the likelihood of achieving these goals. Timely initiation, close monitoring and continuous adjustment are the cornerstones of optimal chelation therapy in children, who have a higher transfusional requirements compared to adults in order to reach haemoglobin levels adequate for normal growth and development. Despite increased knowledge, there are still uncertainties about the level of body iron at which iron chelation therapy should be started and about the appropriate degree of iron stores' depletion. © 2014 John Wiley & Sons Ltd.