Hepatocellular carcinoma (HCC), following liver cirrhosis as a complication of chronic hepatitis B or C viruses (HBV or HCV)and iron overload, has been reported in thalassemia patients. This study assessed HCC incidences, the role of iron and possible antitumor activity of chelators in 57 thalassemia major (TM) and nine thalassemia intermedia (TI) patients using deferoxamine (DFO) therapy. Antibodies against HCV were detected in 23/57 (40.4%) TM patients, chronic HCV and cirrhosis were diagnosed in 13/23 (56.5%), 7/12 did not respond to antiviral therapy and 2/7 progressed to HCC (incidence 2/57, 3.5%). Three (33.3%) TI patients with liver siderosis and fibrosis and late introduction of iron chelation developed HCC without a history of hepatitis. The incidence was higher in TI (p = 0.032). The main risk factor for HCC was HCV infection in TM patients but it was iron activity in TI patients. Iron chelation with DFO appeared to play a protective role.
Beta-thalassemia major (beta-TM), patients, asymptomatic and with preserved left ventricular ejection fraction (LVEF) were studied echocardiographically. Group A (26 patients), on deferiprone (L1) and deferoxamine (DFO) combination therapy (L1: 80 +/- 27 mg/kg/day, DFO: 160 +/- 87 mg/kg/week) and group B (35 patients) on DFO monotherapy (240 +/- 40 mg/kg/week) for the last 2 years were compared. Another group, C (14 patients), switched to L1 (74 +/- 15 mg/kg/day) plus DFO (158 +/- 48 mg/kg/week) for 20-30 months, was prospectively studied for 2 years. In group A, MRI T2* values were increased and improved in group C during follow-up. The LVEF was better in group A than in group B, while such an improvement was also detected in the group C follow-up study. The Tissue Doppler study E' velocity and E/E' ratio was not different. Similarly, in the group C follow-up no significant change in E/E' ratio was detected. It seems that although LVEF significantly improves with combined therapy, diastolic function indexes do not show a similar change.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.