Lack of progressive hepatic fibrosis during long-term therapy with deferiprone in subjects with transfusion-dependent beta-thalassemia
Autor: | Wanless, I. R., Sweeney, G., Dhillon, A. P., Guido, M., Piga, Antonio Giulio, Galanello, A., Gamberini, R., M. R., Schwartz, Cohen, E., A. R. |
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Rok vydání: | 2002 |
Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Time Factors Adolescent Pyridones Biopsy Thalassemia Immunology Iron Chelating Agents Biochemistry Gastroenterology chemistry.chemical_compound Fibrosis Internal medicine medicine Humans Blood Transfusion Deferiprone Chelation therapy Child medicine.diagnostic_test business.industry beta-Thalassemia Beta thalassemia Cell Biology Hematology Hepatitis C medicine.disease Surgery chemistry Liver biopsy Female Hepatic fibrosis business |
Zdroj: | Blood. 100:1566-1569 |
ISSN: | 1528-0020 0006-4971 |
Popis: | Patients with thalassemia major require lifelong chelation therapy to prevent iron-induced organ damage. The orally active chelator deferiprone has been proposed as an alternative for patients unable or unwilling to use deferoxamine. One report has concluded that deferiprone may worsen hepatic fibrosis in patients with thalassemia, whereas others have found no detrimental effect. A panel of 3 pathologists evaluated 112 coded liver biopsies obtained from 56 patients before and after deferiprone therapy. Fibrosis was scored with the Laennec and Ishak systems. The mean interval between liver biopsies was 3.1 years (range, 1.2-4.9 years). In 11 patients seronegative for hepatitis C, fibrosis scores before and after therapy were 1.12 +/- 1.07 and 0.97 +/- 0.84 (P =.42) with the use of the Ishak system, and 0.71 +/- 0.65 and 0.70 +/- 0.53 (P =.91) with the Laennec system. Among 45 patients seropositive for hepatitis C, fibrosis scores before and after therapy were 1.91 +/- 1.13 and 2.04 +/- 1.30 (P =.43) with the use of the Ishak system and 1.26 +/- 0.73 and 1.35 +/- 0.90 (P =.41) with the Laennec system. When the data set was limited to biopsies that each contained 6 or more portal tracts (31 patients), analysis still showed no significant change in fibrosis with time. With the use of the Laennec system, the fibrosis score did not increase by more than one level in any patients without hepatitis C; it increased by more than one level in 1 patient with hepatitis C; and it did not decrease by more than one level in any of the 56 patients. This analysis of the largest collection of liver biopsies reported to date in patients receiving deferiprone demonstrates no evidence of deferiprone-induced progression of hepatic fibrosis during long-term therapy. |
Databáze: | OpenAIRE |
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