Understanding Iron Overload: Screening, Monitoring, and Caring for Patients With Transfusion-Dependent Anemias

被引:11
作者
Ault, Patricia [1 ]
Jones, Karen [2 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
[2] Baylor Coll Med, Houston, TX 77030 USA
关键词
BETA-THALASSEMIA MAJOR; QUALITY-OF-LIFE; MYELODYSPLASTIC SYNDROMES; MAGNETIC-RESONANCE; DEFERASIROX ICL670; CHELATION-THERAPY; MEDICAL PROGRESS; SERUM FERRITIN; DEFEROXAMINE; COMPLICATIONS;
D O I
10.1188/09.CJON.511-517
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Patients receiving recurring blood transfusions as supportive therapy to treat chronic anemias, such as myelodysplastic syndromes, thalassemia, and sickle-cell disease, are at risk of iron accumulation. The clinical consequences of iron overload are progressive liver damage, cardiac disease, and endocrine disorders,which can be fatal. Nurses have a vital role in the initial assessment and monitoring of patients undergoing transfusion therapy and their ongoing care. Iron levels may be managed effectively with iron chelation therapy, and treatment guidelines recommend initiation when serum ferritin levels reach more than 1,000 mcg/L. Deferoxamine has been used effectively in clinical practice for more than 40 years. Newer agents, such as deferasirox, have introduced the option of oral therapy to manage iron overload. Those agents and practical management of patients receiving multiple blood transfusions are discussed.
引用
收藏
页码:511 / 517
页数:7
相关论文
共 58 条
[11]   EFFICACY OF DEFEROXAMINE IN PREVENTING COMPLICATIONS OF IRON OVERLOAD IN PATIENTS WITH THALASSEMIA MAJOR [J].
BRITTENHAM, GM ;
GRIFFITH, PM ;
NIENHUIS, AW ;
MCLAREN, CE ;
YOUNG, NS ;
TUCKER, EE ;
ALLEN, CJ ;
FARRELL, DE ;
HARRIS, JW .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (09) :567-573
[12]   Long-term treatment with deferasirox (Exjade®, ICL670), a once-daily oral iron chelator, is effective in patients with transfusion-dependent anemias [J].
Cappellini, Maria Domenica ;
Vichinsky, Elliott ;
Galanello, Renzo ;
Piga, Antonio ;
Williamson, Paul ;
Porter, John B. .
BLOOD, 2007, 110 (11) :816A-816A
[13]   Prospective evaluation of patient-reported outcomes during treatment with deferasirox or deferoxamine for iron overload in patients with β-thalassemia [J].
Cappellini, Maria Domenica ;
Bejaoui, Mohamed ;
Agaoglu, Leyla ;
Porter, John ;
Coates, Thomas ;
Jeng, Michael ;
Lai, Maria Eliana ;
Mangiagli, Antonio ;
Strauss, Gabriele ;
Girot, Robert ;
Watman, Nora ;
Ferster, Alina ;
Loggetto, Sandra ;
Abish, Sharon ;
Cario, Holger ;
Zoumbos, Nicolaos ;
Vichinsky, Elliott ;
Opitz, Herbert ;
Ressayre-Djaffer, Catherine ;
Abetz, Linda ;
Rofail, Diana ;
Baladi, Jean-Francois .
CLINICAL THERAPEUTICS, 2007, 29 (05) :909-917
[14]   A phase 3 study of deferasirox (ICL670), a once-daily oral iron chelator, in patients with β-thalassemia [J].
Cappellini, MD ;
Cohen, A ;
Piga, A ;
Bejaoui, M ;
Perrone, S ;
Agaoglu, L ;
Aydinok, Y ;
Kattamis, A ;
Kilinc, Y ;
Porter, J ;
Capra, M ;
Galanello, R ;
Fattoum, S ;
Drelichman, G ;
Magnano, C ;
Verissimo, M ;
Athanassiou-Metaxa, M ;
Giardina, P ;
Kourakli-Symeonidis, A ;
Janka-Schaub, G ;
Coates, T ;
Vermylen, C ;
Olivieri, N ;
Thuret, I ;
Opitz, H ;
Ressayre-Djaffer, C ;
Marks, P ;
Alberti, D .
BLOOD, 2006, 107 (09) :3455-3462
[15]   Overcoming the challenge of patient compliance with iron chelation therapy [J].
Cappellini, MD .
SEMINARS IN HEMATOLOGY, 2005, 42 (02) :S19-S21
[16]  
Cohen Alan R, 2004, Hematology Am Soc Hematol Educ Program, P14
[17]   Iron chelation therapy in sickle cell disease [J].
Cohen, AR ;
Martin, MB .
SEMINARS IN HEMATOLOGY, 2001, 38 (01) :69-72
[18]  
CONTE D, 1986, LIVER, V6, P310
[19]   Complications of β-thalassemia major in north America [J].
Cunningham, MJ ;
Macklin, EA ;
Neufeld, EJ ;
Cohen, AR .
BLOOD, 2004, 104 (01) :34-39
[20]   PROLONGED SURVIVAL IN PATIENTS WITH BETA-THALASSEMIA MAJOR TREATED WITH DEFEROXAMINE [J].
EHLERS, KH ;
GIARDINA, PJ ;
LESSER, ML ;
ENGLE, MA ;
HILGARTNER, MW .
JOURNAL OF PEDIATRICS, 1991, 118 (04) :540-545