Deferiprone effectiveness in thalassemia major children with or without hepatitis B or C virus infection: a non-randomized study

Yovita Ananta; Pustika Amalia Wahidiyat; Hanifah Oswari

doi:10.14238/pi50.2.2010.105-12

Yovita Ananta Department of Child Health, Medical School, University of lndonesia, Cipto Mangunkusumo Hospital
Pustika Amalia Wahidiyat Department of Child Health, Medical School, University of lndonesia, Cipto Mangunkusumo Hospital
Hanifah Oswari Department of Child Health, Medical School, University of lndonesia, Cipto Mangunkusumo Hospital

DOI: https://doi.org/10.14238/pi50.2.2010.105-12

Keywords: deferiprone, thalassemia, hepatitis B, hepatitis C, effectiveness

Abstract

Background A high incidence rate of hepatitis B or C virus
infection is found among thalassemia children in Indonesia. This
may influence deferiprone effectiveness.
Objective To determine the effectiveness of deferiprone in
thalassemia children with or without hepatitis B or C virus
infection.
Methods A non-randomized clinical study was performed at
Thalassemia Center Jakarta. Subjects were thalassemia children
with serum ferritin level > 1000 ng/mL who had hepatitis B or
C virus infection. A match control pair was recruited based on
similar duration of transfusion therapy, thalassemia type, and
initial serum ferritin level. All subjects received initial deferiprone
dose of 50 mg/kg/day for 3 months. Those whose ferritin decreased
2:: 10% continued to receive deferiprone of 50 mg/kg/day for the
following 3 months. Otherwise, deferiprone dose was adjusted
to 75 mg/kg/day.
Results Forty-eight subjects were recruited. After 3 months of
treatment, 16/24 subjects without and 6/24 subjects with hepatitis
B or C had their ferritin level decreased 2:: 10%. Mean ferritin
serum level of all subjects after 6 months was significantly reduced
from 4734 (SD 2116) to 3695 (SD 1709) ng/mL. Lower mean
deferiprone dose, lower mean post- study ferritin serum level and
higher mean percentage of ferritin serum level decrement were
found in subjects without hepatitis B or C infection than those
with infection.
Conclusions Deferiprone 50-7 5 mg/kg/day for 6 months is effective
in reducing serum ferritin level of thalassemia major children; it
is more effective in thalassemia children without hepatitis B or C
virus infection.

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