Monitoring long-term efficacy of iron chelation treatment with biomagnetic liver susceptometry.
Monitoring long-term efficacy of iron chelation treatment with biomagnetic liver susceptometry.
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DOI：
10.1196/annals.1345.043
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Nielsen, P
中科院分区：
文献类型：
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作者：
Fischer, R;Piga, A;Nielsen, P
在地中海贫血患者中，肝脏铁浓度（LIC）的评估可用于启动去铁胺（DFO）、去铁酮（DFP）或新型螯合剂（地拉罗司）的螯合治疗;根据实际输血率调整螯合剂量;以及监测螯合疗效。在大约1000名患者的LIC范围17- 11，500 μ g/g肝脏中，使用SQUID生物磁肝脏电阻测量法的测量结果来导出非标准参数，这可能对地中海贫血患者的治疗监测有用。根据这些测量值，包括肝脏体积、记录的螯合剂量率和输血率，计算螯合剂指数（等效治疗指数）、全身铁消除率和摩尔效力。螯合剂指数（CIS）范围为0.1至11.7 mmol/d/g的铁DFO，与阈值的Cl大于1.2 mmol/d/g的铁表明DFO毒性。对于DFP，CI范围为0.1至23.2 mmol/d/g Fe。在长期研究（2年和4年）中，发现DFO和DFP的平均磨牙有效性相当稳定，分别为17.6 +/- 4.8%和4.9 +/-1.4%。目前，具体螯合剂量是基于体重。由于通过生物电测量法进行的肝脏铁测量现在在欧洲和美国定期可用，以及全球范围内的定量MRI，这些方法可用于调整螯合治疗方案以适应身体铁储存。
In patients with thalassemia, the assessment of liver iron concentration (LIC) can be used to initiate chelation treatment with desferrioxamine (DFO), deferiprone (DFP), or novel chelators (deferasirox); to adjust chelation dose according to the actual blood transfusion rate; and to monitor chelation efficacy. The results from measurements by SQUID biomagnetic liver susceptometry in the LIC range 17-11,500 mu g/g of liver in about 1000 patients were used to derive nonstandard parameters, which may be useful in the treatment monitoring of patients with thalassemia. From these measurements, including liver volumes, the documented chelation dose rates, and the blood transfusion rates, the chelator index (equivalent Therapeutical Index), the total body iron elimination rate, and the molar efficacy were calculated. Chelator indices (CIS) ranged from 0.1 to 11.7 mmol/d/g of Fe for DFO, with a threshold of Cl greater than 1.2 mmol/d/g of Fe indicating DFO toxicity. For DFP, CI ranged from 0.1 to 23.2 mmol/d/g of Fe. In long-term studies (2 and 4 years), mean molar efficacies of DFO and DFP were found to be quite stable with 17.6 +/- 4.8% and 4.9 +/- 1.4%, respectively. Currently, specific chelation dose is based upon body weight. Because liver iron measurements by biosusceptometry are now regularly available in Europe and America, as well as quantitative MRI worldwide, these methods may be used to adjust chelation treatment regimens to body iron stores.