SUBCUTANEOUS BOLUS INJECTION OF DEFEROXAMINE IN ADULT PATIENTS AFFECTED BY ONCO-HEMATOLOGIC DISEASES AND IRON OVERLOAD

Background and Objective. Chelation therapy is often necessary for pat ients who undergo chronic transfusion therapy for myelodysplastic synd romes. In these patients, deferoxamine, the most widely used chelating agent, has been reported to be effective in reducing the iron burden and the transfusion requirement. Unfortunately, compliance with the dr ug, that is usually administered by slow subcutaneous infusion via a b attery operated pump, is often poor, especially in elderly patients. D esign and Methods. To verify efficacy and tolerability of deferoxamine by subcutaneous bolus injection as compared to the conventional pump- driven slow infusion, eleven patients affected by oncohematologic dise ases were given 2 g of deferoxamine diluted in 10 mL of distilled wate r over twelve hours by continuous infusion, or by bolus injection in t wo divided doses. Results. Mean urinary excretion was comparable with the two methods, being 9,183+/-4,349 mu g/48h after two daily subcutan eous bolus injections and 8,291+/-3,970 mu g/48h with the slow infusio n. The bolus injection was preferred by all eleven patients, who chose to continue chelation therapy by this method. Interpretation and Conc lusions. The iron excretion induced by bolus injection is not statisti cally different from that induced by subcutaneous infusion. The side e ffects are acceptable. Subcutaneous bolus injection of deferoxamine is an acceptable alternative to slow, pump-driven infusion. (C)1998, Fer rata Storti Foundation.