Deferasirox in the treatment of iron overload during myeloproliferative neoplasms in fibrotic phase: does ferritin decrement matter?. (January 2019)

• Record Type: Journal Article
• Authors: Di Veroli, Ambra; Campagna, Alessia; De Muro, Marianna; Maurillo, Luca; Trawinska, Malgorzata Monika; LeonettiCrescenzi, Sabrina; Petriccione, Luca; Romano, Atelda; D'Addosio, Ada; Cenfra, Antonia; Montanaro, Marco; Felici, Stefano; Andriani, Alessandro; Carmosino, Ida; Niscola, Pasquale; Montefusco, Enrico; Breccia, Massimo; Latagliata, Roberto
• Is Part Of: Leukemia research. Volume 76(2019)
• Page Start: 65
• Page End: 69
• Publication Date: 2019-01
• Subjects: Iron overload -- Myeloproliferative neoplasms -- Deferasirox; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2018.11.012
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Iron overload is a major concern in Ph-negative myeloproliferative neoplasms in fibrotic phase. The clinical use of DFX and its benefit are not consolidated FP-MPN. A larger cohort of FP-MPN patients with iron overload treated with DFX was analyzed. A rate of about 40% of global responses in terms of ferritin reduction was observed. FP-MPN patients reaching a reduction of ferritin had a longer OS compared to patients who failed. Abstract: Few data are available on the treatment with DFX in patients with transfusion dependent Ph- Myeloproliferative Neoplasms in fibrotic phase. Here we report 48MPNpatients and iron overload treated with DFX. Starting DFX dose was 20 mg/Kg in 23 patients, 15 mg/Kg in 20 patientsand 10 mg/Kg in 5 patients. After a median treatment of 27.6 months, 5 patients achieved ferritin<500 ng/ml, 11 < 1000 ng/ml and 3 a reduction >50% of basal ferritin with a global response rate of 41%. As to hematological improvement, 9/47 patients (19.1%) showed a persistent rise of Hb>1.5 g/dl, with disappearance of transfusion requirement in 6 cases. The median OS from DFX initiation in patients with chelation response was 61.0 months compared to 15.8 months in patients without chelation efficacy. Treatment with DFX is feasible and effective in MPN with iron overload and a hematological improvement can occur in a sizeable rate of patients.