Assessment of serum ferritin levels in transfusion dependent thalassemic children on oral deferiprone in a tertiary care centre

Suman Chirla, Lalita Wadhwa, Puneet Wadhwa


Background: Thalassemic patients require regular blood transfusions to maintain haemoglobin level around between 10gm/dl-15gm/dl, which would result in transfusional iron overload. The treatment of iron overload is carried out by using parenteral desferrioxamine (DFX) therapy or recently introduced oral Deferiprone (DFP,L1,Ferriprox,KELFER,CP20) an oral iron chelator, Oral deferiprone, DFP (3-hydroxy-1,2-dimethylpyridin-4-one) is a synthetic analogue of mimosine, an iron chelator isolated from the legume Mimosa paduca. Our study was undertaken to asses ferritin concentration in transfusion dependent thalassemic children on Deferiprone, attending thalassemia clinic in Anil Neerukonda hospital, Sanghivalasa, Visakhapatnam.

Methods: The present study was a hospital based prospective study, 50 transfusion dependent thalassemic children on Deferiprone, attending thalassemia clinic in Anil Neerukonda hospital, Sanghivalasa, Visakhapatnam attached to NRI Medical College, Visakhapatnam were enrolled during the study period October 2017 and September 2018.

Results: In our study authors found an increase in Serum ferritin concentration from 3067.99±1520.13 to 4281.10 ±1760.42 ng/ml at the end of 12 months, which was quite significant.

Conclusion: Authors concluded that oral Deferiprone is not an effective iron chelation agent and is associated with complications like GI symptoms, joint pains in significant number of children. So, search for an alternative iron chelator or combined chelation therapies which are safe and cost effective should be continued.


Oral Deferiprone, Serum ferritin levels, Thalassaemia

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Sarnaik SA. Thalassemia and Related Hemoglobinopathies. Indian J Paediatr. 2005; 72(4):319-24.

Kumar V. Disease of red cells and bleeding disorders. In: Robbins textbook of pathology basis of disease, 5th edn. Cotran RS, Kumar V, and Robbins SL. India: WB Saunders, 1994, 583-627.

Quirolo Keith and Elliot Vichinsky. Thalassemia syndromes. In: Nelson Textbook of Pediatrics, 17th edn. Behrman RE, Kliegman RM and Jenson HB (eds). India. Elsevier, 2004, 1630-34.

Weatherall DJ. The thalassemias. In: Stamatoyannopoulos G, Nienhuis AW, Majerus PH, Varmus H, eds. The molecular basis of blood diseases. 2nd ed. Philadelphia: W.B. Saunders, 1994:157-205.

Weatherall DJ. Common genetic disorders of the red cell and the "malaria hypothesis" Annals of Tropical Medicine Parasitol. 1987;81(5):539-48.

Lokeshwar MR, Mamta Manglani, Nitin Shaw, Swathi Kanakia: Modern trends in the management of Thalassemia, Indian J practical Pediatr. 1997;5:287-95.

Choudhry VP, Desai. N Pati HP, Nanu A: Current Management of homozygous ß Thalassemia, Indian paediatr. 1991;28(10):1221-29.

Choudhry VP, Kashyap R, Acharya SK, Tandon N, Saxena A: Challenges in the Management of Thalassaemia, Mediquest Medical Information series. 1997:15(3):1-9.

Mukherji M. Cooley's anaemia (erythroblastic or Mediterranean anaemia) Indian J Pediatr. 1938;5(1):1-7.

Gomber S, Saxena R, Madan N. Comparative efficacy of desferrioxamine, deferiprone and in combination on iron chelation in thalassemic children. Indian pediatr. 2004 Jan 7;41(1):21-8.

Choudhry VP, Pati HP, Saxena A, Malaviya AN. Deferiprone, efficacy and safety. The Indian J Pediatr. 2004 Mar 1;71(3):213-6.

George A, Bhaduri A, Sen S, Choudhry VP. Physical growth parameters in thalassemic children. Indian J Pediatr. 1997;64(6):861-71.

Olivieri NF, Brittenham GM, McLaren CE, Templeton DM, Cameron RG, McClelland RA, et al. Long-Term Safety and Effectiveness of Iron Chelation Therapy with Deferiprone for Thalassemia Major. New England J Medicine.1998;339(7):417-23.

Agarwal MB. Long term assessment of efficacy and safety of L1, an oral iron chelator, in transfusion dependent thalassemia: Indian trial. British J Haematol.1992;82:460-6.