Journals / Acta Medica / 2019 / Cilt: 50 - Sayı: 3

The Safety of Chelators for Iron Overload in Sickle Cell Disease: A Brief Systematic Review

Pages
50–60
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Furthermore, current reports do not reflect any significant safety con-cerns against the use of available chelators.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Sickle cell disease is a group of disorders that affects hemoglobin due to a mutation of the hemoglobin beta gene on chromosome 11.
📊
Key Findings & Data:Because of the high concentration of hemoglobin S in patients, a high risk of chronic anemia and vaso-occlusive events, such as stroke may deteriorate suddenly.
💡
Conclusion & Impact:Furthermore, current reports do not reflect any significant safety con-cerns against the use of available chelators.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Sickle cell disease is a group of disorders that affects hemoglobin due to a mutation of the hemoglobin beta gene on chromosome 11. Patients have atypical hemoglobin molecules called hemoglobin S, which distort erythro-cytes into a “sickle-shape”. Typical symptoms of disease include periodic ep-isodes of pain, repeated infections, and anemia. This disorder is abundant in sub-Saharan African countries, the Mediterranean region, and also appears in some southern provinces in Turkey. Because of the high concentration of hemoglobin S in patients, a high risk of chronic anemia and vaso-occlusive events, such as stroke may deteriorate suddenly. In these conditions, trans-fusion of blood, especially erythrocytes, can be life-saving. However, chronic blood transfusions may lead to iron overload in patients. Erythrocyte trans-fusion is associated with a higher risk in most patients with sickle cell disease than in the general population. Therefore, chelation therapy has become an important component of the transfusion program to prevent complica-tions of iron accumulation in organs such as liver and heart. In this study, we sought to conduct a systematic review to assess the safety of iron chelat-ing agents used by patients with iron overload mainly due to necessary blood transfusion regime. Our evaluation revealed that in general iron chelation therapy, either deferasirox, deferoxamine or deferiprone, remains the most effective and safest available method to treat iron overload in sickle cell dis-ease. Furthermore, current reports do not reflect any significant safety con-cerns against the use of available chelators.

🔖

Cite This Article

RADWAN, B., BOŞGELMEZ, İ. İ. (2019). The Safety of Chelators for Iron Overload in Sickle Cell Disease: A Brief Systematic Review. Acta Medica, Cilt: 50 - Sayı: 3, 50–60. https://ajindex.com/articles/142570

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (11)

  1. Williams TN, Weatherall DJ. World distribution, population genetics, and health burden of the hemoglobinopathies. Cold Spring Harb Perspect Med 2012; 2(9): a011692. Piel FB, Tatem AJ, Huang Z, et al. Global migration and the changing distribution of sickle haemoglobin: a quantitative study of temporal trends between 1960 and 2000. Lancet Glob Heal 2014; 2(2): e80-9. Piel FB, Hay SI, Gupta S, et al. Global burden of sickle cell anaemia in children under five, 2010–2050: Modelling based on demographics, excess mortality, and interventions. PLoS Med 2013; 10(7): e1001484. Ashley-Koch A, Yang Q, Olney RS. Sickle hemoglobin (HbS) allele and sickle cell disease: a HuGE review. Am J Epidemiol 2000; 151(9): 839-45.
  2. Kato GJ, Piel FB, Reid CD, et al. Sickle cell disease. Nat Rev Dis Prim 2018; 4: 18010. Redding-Lallinger R, Knoll C. Sickle cell disease--patho-physiology and treatment. Curr Probl Pediatr Adolesc Health Care.2006; 36(10): 346-76.
  3. Chirico EN, Pialoux V. Role of oxidative stress in the patho-genesis of sickle cell disease. IUBMB Life 2012; 64(1): 72–80.
  4. Aslan M, Ryan TM, Adler B, et al. Oxygen radical inhibition of nitric oxide-dependent vascular function in sickle cell disease. Proc Natl Acad Sci 2001; 98(26): 15215–20.
  5. Voskou S, Aslan M, Fanis P, et al. Oxidative stress in β-thalas-saemia and sickle cell disease. Redox Biol 2015; 6: 226–39.
  6. Oztas Y, Durukan I, Unal S, et al. Plasma protein oxidation is correlated positively with plasma iron levels and negatively with hemolysate zinc levels in sickle-cell anemia patients. Int J Lab Hematol 2012; 34(2): 129–35.
  7. Lobitz S, Telfer P, Cela E, et al. Newborn screening for sickle cell disease in Europe: recommendations from a Pan-European Consensus Conference. Br J Haematol 2018;183(4): 648–60.
  8. Kapoor S, Little JA, Pecker LH. Advances in the Treatment of Sickle Cell Disease. Mayo Clin Proc 2018; 93(12): 1810–24. Gluckman E. Allogeneic transplantation strategies in-cluding haploidentical transplantation in sickle cell disease. Hematology Am Soc Hematol Educ Program 2013; 2013: 370-6.
  9. Mulaku M, Opiyo N, Karumbi J, et al. Evidence review of hydroxyurea for the prevention of sickle cell complications in low-income countries. Arch Dis Child 2013; 98(11): 908-14.
  10. Niihara Y, Miller ST, Kanter J, et al. A phase 3 trial of L-glutamine in sickle cell disease. N Engl J Med 2018; 379(3): 226–35.
  11. Niihara Y, Zerez CR, Akiyama DS, et al. Oral L-glutamine therapy for sickle cell anemia: I. subjective clinical improvement an