LIVER IRON STORES IN PATIENTS WITH SECONDARY HEMOSIDEROSIS UNDER IRONCHELATION-THERAPY WITH DEFEROXAMINE OR DEFERIPRONE

Total body iron stores including liver and spleen iron were assessed b y non-invasive SQUID biomagnetometry, The liver iron concentration was measured in groups of patients with beta-thalassaemia major or other post-transfusional siderosis under treatment with the oral iron chelat or deferiprone (n = 19) and/or with parenteral deferoxamine (n = 33). An interquartile range for liver iron concentrations of 1680-4470 mu g /g liver was found in these patients, In both groups a poor correlatio n between liver iron and serum ferritin values was observed. Repeated measurements of liver and spleen iron concentrations as well as determ ination of liver and spleen volume by sonography were performed in six patients under continuous deferiprone treatment for 3-15 months, In t his group detailed information was obtained on the whole body iron sto re (5-36 g) and the iron excretion rates (14-34 mg/d) for each patient . As indicated by decreasing liver iron concentrations, five out of si x subjects showed a negative iron balance (2-13 mg/d). Conventional me asurements of both serum ferritin and urine iron excretion gave fluctu ating results, thus being only of limited use in the control of iron d epletion therapy. The non-invasive biomagnetic liver iron quantificati on is a precise and clinically verified technique which offers more di rect information on the long-term efficacy of an iron depletion therap y than the hitherto used methods. This technique may be of use in the clinical evaluation of new oral iron chelators.