IRON-CHELATING AGENTS IN NON-IRON OVERLOAD CONDITIONS

Purpose: To review the current clinical experience with iron chelators in non-iron overload conditions. Data Sources: The English-language l iterature was searched from 1983 through 1992 manually and using MEDLI NE. Study Selection: Original articles, case reports, and abstracts ad dressing iron chelation. Data Extraction: Selected reports that descri bed clinical applications of iron chelators in non-iron overload condi tions were classified according to their stated mechanism of interfere nce with disease activity. Articles stating the rationale for clinical use of iron chelators were also included. Results: Iron chelators wer e used in non-iron overload conditions to produce antioxidant effects, antiproliferative effects, and antiprotozoal effects and for aluminum chelation. In addition, several reports described singular observatio ns in various diseases. Deferoxamine is the only iron chelator availab le for clinical studies. The treatment-related (side) effects appear t o be associated with patient iron levels. Conclusions: Randomized clin ical trials are needed to confirm the promising effects of iron chelat ors in non-iron overload conditions. Oral iron chelators with fewer to xic effects are especially needed.