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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Deviating from safety guidelines during deferiprone therapy in clinical practice may not be associated with higher risk of agranulocytosis
Pediatric Blood and Cancer, Volume 61, No. 5, Year 2014
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Description
Background: A risk associated with the iron chelator deferiprone is the development of neutropenia or agranulocytosis. Accordingly, the product label recommends weekly blood monitoring and immediate interruption of treatment upon detection of an absolute neutrophil count (ANC) <1.5×109/L, out of concern that continued therapy might lead to a more severe drop. However, it is uncertain how these recommendations are followed under real-life conditions and, if they are not followed, whether continuation of therapy results in increased incidence of agranulocytosis. Procedure: This non-interventional surveillance program assessed the monitoring of deferiprone therapy in clinical practice. A total of 294 patients with transfusion-dependent anemias received deferiprone, as monotherapy or with another chelator, for up to 1 year. The participating physicians were not given any instructions about treatment and monitoring beyond being referred to the information in the package insert. Results: ANC monitoring was conducted at an average interval of 5±4 weeks, and deferiprone was not always interrupted upon detection of neutropenia. One patient (0.3%) experienced agranulocytosis, and nine others (3%) experienced a total of 11 episodes of neutropenia. All neutropenia episodes resolved; median time to resolution was similar whether or not treatment was interrupted; and no case of neutropenia progressed to agranulocytosis. Conclusions: These data indicate that less frequent ANC monitoring and continuation of deferiprone therapy during neutropenia are not associated with prolonged neutropenia or with progression to agranulocytosis. © 2014 Wiley Periodicals, Inc.
Authors & Co-Authors
ElAlfy, Mohsen Saleh
Egypt, Cairo
Ain Shams University
Wali, Y. Ahmed
Oman, Muscat
Sultan Qaboos University Hospital
Qari, Mohamad Hasan
Saudi Arabia, Jeddah
King Abdulaziz University
Al Damanhouri, Ghazi
Saudi Arabia, Jeddah
King Abdulaziz University
Al-Tonbary, Youssef Abdelhalim
Egypt, Mansoura
Mansoura University Children's Hospital
Yazman, Dilek
Cyprus, Nicosia
Dr. Burhan Nalbantoğlu Devlet Hastanesi
Al-Hawsawi, Zakaria M.
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Karakaş, Zeynep
Turkey, Istanbul
Istanbul Üniversitesi
Kılınç, Yurdanur
Turkey, Adana
Çukurova Üniversitesi
Yeşilipek, Mehmet Akif M.
Turkey, Antalya
Akdeniz Üniversitesi
Badr, Mohamed Ahmed
Egypt, Zagazig
Zagazig University
Elsafy, Usama R.
Egypt, Zagazig
Zagazig University
Salama, Mostafa A.S.
Egypt, Alexandria
Faculty of Medicine
Abdel Rahman, Yousryeia
Egypt, Asyut
Assiut University
Shebl, S. S.
Egypt, Tanta
Tanta University
Stilman, Anne
Canada, Toronto
Apopharma Inc.
Toiber Temin, Noemi
Canada, Toronto
Apopharma Inc.
Tricta, Fernando
Canada, Toronto
Apopharma Inc.
Statistics
Citations: 18
Authors: 18
Affiliations: 14
Identifiers
Doi:
10.1002/pbc.24920
ISSN:
15455009
e-ISSN:
15455017
Research Areas
Health System And Policy
Study Design
Cohort Study