Safety and efficacy of subcutaneous bolus injection of deferoxamine in adult patients with iron overload

We compared 48-hour urinary iron excretion after a twice-daily subcutaneous bolus injection of deferoxamine and after 12 hours of subcutaneous continu ous infusion of the drug in 27 patients with iron overload (mean age, 55.7 years). In most patients, the iron overload was due to multiple transfusion s administered during chemotherapy or as part of supportive care for a hema tologic or oncologic disorder. One patient had sickle cell anemia and 1 had hereditary hemochromatosis and spherocytosis, Similar urinary iron excreti on was observed with the 2 methods of administration; mean +/- SD values we re 6935.3 +/- 3832.3 mu g/48 hours with subcutaneous bolus injection and 66 30.4 +/- 3606.9 mu g/48 hours with subcutaneous continuous infusion (P=.3), Twenty-six patients (96.3%) chose to continue therapy with bolus injection . The long-term efficacy of bolus injection was evaluated by measuring the serum ferritin concentration at regular intervals for a follow-up time of 2 0.1 +/- 4.5 months. Ferritin concentration decreased to below 1000 mu g/L i n 73% of the patients and to below 500 mu g/L in 42% and became normal in 2 6%. Best results were obtained in patients who were no longer receiving blo od transfusions when chelation therapy was initiated. Three of 26 patients (11.5%) had mild, transient side effects after bolus injection. Larger pros pective, randomized studies must be conducted before deferoxamine bolus inj ection can be routinely recommended for patients with iron overload. (Blood , 2000;95:2776-2779) (C) 2000 by The American Society of Hematology.