LIVER IRON AND FIBROSIS DURING LONG-TERM TREATMENT WITH DEFERIPRONE IN SWISS THALASSEMIC PATIENTS

Serum ferritin levels, hepatic histology and iron concentration were s tudied in a 'veteran' group of seven Swiss beta-thalassaemic patients after 93-99 months of treatment with the oral iron chelator deferipron e (L1), and another four patients who had received 54-82 months of L1 therapy. Despite continuous compliance, unexplained resurgence of seru m ferritin levels occurred in 4/7 patients of the 'veteran' group afte r 4-5 years on L1. In three of these a concomitant increase of liver i ron was also observed, Hepatic histology revealed significantly higher degrees of fibrosis in 6/11 hepatitis C (HC)-positive patients (fibro sis scores 1-5, mean 3.0) than in the HC-negative group (fibrosis scor e 0-2, mean 0.8). Two HC-negative patients had no detectable fibrosis after 98 and 93 months on deferiprone. Therefore the hepatic pathology in these patients cannot definitely be attributed as a side-effect of deferiprone. Chronic active hepatitis C and the accumulation of iron are the major causative factors to be considered.