Comparison of the effectiveness of the chelator treatments on cardiac and liver iron accumulation in patients with talasemi major

As a result of regular blood transfusions in thalassemia major patients, toxicities due to iron accumulation occur in the body. The most important of these toxicities are cardiac and liver iron overload. Heart failure and arrhythmia due to cardiac iron accumulation are the most common cause of death in TM patients. Most of the body iron accumulates in liver and cause hemacromatosis, hepatitis and cirrhosis development. Various chelator therapies are used to prevent iron accumulation in the body. In this study, the efficacy of chelator treatments on cardiac and hepatic iron accumulation was compared retrospectively using cardiac and liver MRT2 * method. In this study, a total of 64 TM patients who were followed in the Akdeniz University Pediatric Hematology Outpatient Clinic between 01.01.2010-01.01.2018 years and treated with the same chelator therapy for five years in one of deferasirox (DFX), deferiprone (DFP) and combined (deferoxamine (DFO) + DFP) treatments were examined. Cardiac and liver MR T2 * values of the patients were compared in-group and between the groups. Patients using DFX (n=22), DFP (n=20) and DFO + DFP (n=22) had no significant decrease or increase in liver T2* values at the end of five years compared to baseline values. In addition, there was no difference between the efficacy of chelator therapies when comparing between three groups. Similarly, no significant increase or decrease in cardiac T2* values was observed when compared to baseline values in three groups. When the comparisons were made between the three groups, there was no difference between the efficacy of the chelator therapies. As a result, no difference was observed in liver and cardiac T2* values at the end of five years in patients using DFX, DFP and DFO + DFP. Our study is the first study in the literature which compares the five-year efficacy of these three chelator treatment models on cardiac and liver MRI T2*. Key words: Defarasirox, deferiprone, deferoxamine, cardiac MRT2*, liver MRT2*