地拉罗司治疗铁质积聚效果如何？

It is mainly suitable for patients with iron accumulation due to long-term blood transfusion (such as those suffering from thalassemia or other rare anemias). Deferasirox is suitable for children over two years old and adults. Deferasirox should not be combined with other iron chelation therapies because the safety of such combined use has not been established. Deferasirox is contraindicated in patients with creatinine clearance <40mL/min or serum creatinine >2 times the upper limit of normal for the corresponding age; patients with poor general condition, high-risk myelodysplastic syndrome (MDS) or advanced malignant tumors; patients with platelet count <50x109/L.

The iron-removing efficacy of 64 AA patients with iron overload after 12 months of deferasirox treatment was analyzed, and the safety was evaluated. Results The starting dose of deferasirox for all patients was 20.0 mg·kg-1·d-1, and the average dose was (18.6±3.60) mg·kg-1·d-1. After 12 months of treatment, the median serum ferritin (SF) level dropped from the baseline of 4 924 (2 718 to 6 765) μg/L (64 cases) to 3 036 (1 474 to 5 551) μg/L (23 cases), a decrease of 38%, and the median SF reduction was 651 (126 to 2 125) μg/L; the median SF level of 23 patients who completed 12 months of treatment dropped from the baseline of 5 271 (3 420 ~ 8 278) μg/L to 3 036 (1 474 ~ 5 551) μg/L, a decrease of 42%, and the median SF reduction was 1 167 (580 ~ 4 806) μg/L.

For the 38 patients who were concurrently taking cyclosporine, 12 patients (31.8%) had creatinine values >the upper limit of normal (ULN) for 2 consecutive times, 10 patients (26.3%) had creatinine values >1.33 baseline value for 2 consecutive times, and only 1 patient (2.6%) had serum creatinine that increased beyond the 1.33 baseline value and exceeded the ULN. For AST and ALT, no patient throughout the study had two post-baseline values ​​>5×ULN or >10×ULN. For patients with baseline PLT levels below 50 × 109/L, median PLT did not decrease during deferasirox treatment.

Conclusion: Treatment of AA patients with iron overload can achieve good iron removal efficacy, the drug is well tolerated, and there are no clinically uncontrollable serious adverse events.