"Gattermann et al. [Haematologica,
2012; 97(9): 1364-1371] have recently published
data on the impact of chelation therapy with deferasirox (Exjade) on hemoglobin levels,
platelet counts, and neutrophil counts in patients with transfusion-dependent MDS.
To be included in the trial, patients must have:
data on the impact of chelation therapy with deferasirox (Exjade) on hemoglobin levels,
platelet counts, and neutrophil counts in patients with transfusion-dependent MDS.
To be included in the trial, patients must have:
- Been diagnosed with iron overload (serum ferritin > 1,000 μg/L or LIC > 2 mg-Fe/g-dw)
- Had a history of multiple blood transfusions (> 20 transfusions or > 100 ml/Kg
- of RBCs)
- Not be on a concomitant disease modifying agent for MDS (e.g., Vidaza, Dacogen,
- Revlimid)
Recruited patients
were treated with deferasirox for 1 year of active treatment – there
was no control arm in the trial design. The following table summarizes the main study findings:"
was no control arm in the trial design. The following table summarizes the main study findings:"
Erythroid analysis | Platelet analysis | Neutrophil analysis | |
Eligible patients | 247 | 100 | 50 |
Inclusion criteria | Pre-treatment HB < 11 g/dl, OR RBC transfusion requirements > 4 units per 8 weeks |
Pre-treatment platelets < 100 x 109/L | Pre-treatment ANC < 1.0 x 109/L |
Definition of response | HB increase > 1.5g/dL, OR reduction of ≥ 4 RBC transfusions per 8 weeks |
Increase > 30 x 109/L for patients below 20 x 109/L, or > 100% increase | > 100% increase, AND absolute increase > 0.5 x 109/L |
Response rate | 21.5% | 13% | 22% |
Median days to response | 109 | 169 | 226 |
Mean actual deferasirox dose, mg/kg/day | ~19.3 | ~19.5 | ~18.8 |