• Ghazal Usman Shaikh Zayed Hospital Lahore-Pakistan
  • Mahfooz ur Rehman Punjab Institute of Cardiology Lahore-Pakistan
  • Shifa Khalil Shaikh Zayed Hospital Lahore-Pakistan
  • Muhammad Sarmad Hafeez Information Technology University Lahore-Pakistan


Thalassemia, iron chelating, agents, Deferoxamine, Drug therapy, Combination


Background: Thalassemia has high prevalence and carrier rate of 8 – 10% in Pakistan, repeated blood  transfusions lead to iron  deposition  in  organs. In this Prospective study we have compared  the efficacy  of three  chelation  regimens being used in  our country. It has been conducted at PBTS, Fatmid  Foundation and Children   Hospital  Lahore. Methods:  60 thalassemia  major  patients, were divided  into  3  groups according  to  their  mode  of chelation.  Patients in group  I  were on oral  iron  chelator  deferiprone, 7  days  per  week. Thalassemics  in  group  II  were on parenteral  iron  chelator  deferoxamine  given  subcutaneously  for  4  days in a week, and group  III  patients  were on  combination  therapy, deferiprone for 5 days & deferoxamine  given  twice  weekly.  The  assessment  of  chelation  was  done  by  measurement  of  serum  ferritin and  24  hour urinary  iron  excretion  at  the  start  of study  and then  after  six  months  of  follow  up.  To  assess  the  hepatic  iron,  hepatic  MRI  were  also  performed.  Results:   Ferritin  levels were  maximally  decreased  in  group  II,  followed  by  group  III, with  no  significant  reduction in group  I. However  statistically  significant  difference  in  mean  urinary  iron  excretion (increased) was  seen  in  group III. The  hepatic  iron  was  very  high  in  all  three  groups  as  shown  by  the  hepatic  MRI. Conclusion: Combination  chelation  therapy  is  the  most  effective  chelation  therapy  in  iron  overloaded patients. It helps  improve  the  compliance and increases urinary iron excretion. Patients on DFX  have  lowest  degree  of  hepatic  siderosis   even  though  it is  considerably  higher  than  normal  population.

Author Biographies

Ghazal Usman, Shaikh Zayed Hospital Lahore-Pakistan


Mahfooz ur Rehman, Punjab Institute of Cardiology Lahore-Pakistan


Shifa Khalil, Shaikh Zayed Hospital Lahore-Pakistan


Muhammad Sarmad Hafeez, Information Technology University Lahore-Pakistan

Project Manager


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