Deferoxamine treatment during pregnancy: Is it harmful?

Singer, Sylvia T.; Vichinsky, Elliott

doi:10.1002/(sici)1096-8652(199901)60:1<24::aid-ajh5>3.0.co;2-c

Cited by 64 publications

(38 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mean age at the time of the first pregnancy was 29.5±4.5 years (range, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] in the group of women with thalassemia major and 30.7±5.6 years (range, in the group with thalassemia intermedia. Women with thalassemia major had received regular transfusions and iron chelation since the age of 2 years.…”

Section: Pre-pregnancy Medical Historymentioning

confidence: 70%

“…Therefore, discontinuation of iron chelation with deferoxamine should be recommended once a pregnancy has been achieved. 22,23 Nevertheless, in patients at high risk (severe heart and liver iron overload) it may be reasonable to consider restarting chelation therapy with deferoxamine towards the end of the second trimester, if MRI demonstrates significant increases in cardiac and/or liver iron.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

106

141

View full text Add to dashboard Cite

BackgroundRecent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children. Design and MethodsWe describe the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies). Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with thalassemia major and spontaneously in all of those with thalassemia intermedia. ResultsAmong the women with thalassemia major, 91% of the pregnancies resulted in successful delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary complications of iron overload developed or worsened during pregnancy. When considering only the singleton pregnancies, the proportion of babies with intrauterine growth retardation did not differ from that reported in the general Italian population. The high prevalence of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However, women with thalassemia intermedia who had never previously been transfused or who had received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood transfusions were required during pregnancy. ConclusionsProvided that a multidisciplinary team is available, pregnancy is possible, safe and usually has a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism, gonadal function is usually intact and fertility is usually retrievable.Key words: pregnancy, thalassemia major, thalassemia intermedia, hypogonadism, assisted reproduction.Citation: Origa R, Piga A, Quarta G, Forni GL, Longo F, Melpignano A, and Galanello R. Pregnancy and β-thalassemia: an Italian multicenter experience. Haematologica. 2010; 95:376-381. doi:10.3324/haematol.2009 This is an open-access paper.Pregnancy and β β-thalassemia: an Italian multicenter experience

show abstract

Section: Pre-pregnancy Medical Historymentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

106

141

View full text Add to dashboard Cite

show abstract

“…Review of the reports on DFO use in various periods of gestation in more than 40 pregnancies, revealed no toxic or teratogenic effects [253]. In an animal model, developmental toxicity in mice was observed, but it appears that it occurred only in the presence of overt maternal toxicity, suggesting that the cause of fetotoxicity were toxic effects in pregnant mothers, and not DFO-related depletion of essential elements in the fetus [254].…”

Section: Deferoxamine (Dfo)mentioning

confidence: 99%

Chelators as Antidotes of Metal Toxicity: Therapeutic and Experimental Aspects

Blanuša¹,

Varnai²,

Piasek³

et al. 2005

CMC

237

150

View full text Add to dashboard Cite

The effects of chelating drugs used clinically as antidotes to metal toxicity are reviewed. Human exposure to a number of metals such as lead, cadmium, mercury, manganese, aluminum, iron, copper, thallium, arsenic, chromium, nickel and platinum may lead to toxic effects, which are different for each metal. Similarly the pharmacokinetic data, clinical use and adverse effects of most of the chelating drugs used in human metal poisoning are also different for each chelating drug. The chelating drugs with worldwide application are dimercaprol (BAL), succimer (meso-DMSA), unithiol (DMPS), D-penicillamine (DPA), N-acetyl-D-penicillamine (NAPA), calcium disodium ethylenediaminetetraacetate (CaNa(2)EDTA), calcium trisodium or zinc trisodium diethylenetriaminepentaacetate (CaNa(3)DTPA, ZnNa(3)DTPA), deferoxamine (DFO), deferiprone (L1), triethylenetetraamine (trientine), N-acetylcysteine (NAC), and Prussian blue (PB). Several new synthetic homologues and experimental chelating agents have been designed and tested in vivo for their metal binding effects. These include three groups of synthetic chelators, namely the polyaminopolycarboxylic acids (EDTA and DTPA), the derivatives of BAL (DMPS, DMSA and mono- and dialkylesters of DMSA) and the carbodithioates. Many factors have been shown to affect the efficacy of the chelation treatment in metal poisoning. Within this context it has been shown in experiments using young and adult animals that metal toxicity and chelation effects could be influenced by age. These findings may have a bearing in the design of new therapeutic chelation protocols for metal toxicity.

show abstract

“…At least 40 cases of pregnancy have been reported in which deferoxamine was given without any teratogenic effect. 23 Thus, it is unlikely that maternal iron chelation therapy was the cause of the observed birth defects in our patient.…”

Section: Discussionmentioning

confidence: 99%

Phenocopy of Warfarin Syndrome in an Infant Born to a Mother With Sickle Cell Anemia and Severe Transfusional Iron Overload

Pivnick

Cohen

et al. 2013

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Neonatal chondrodysplasia punctata (CDP) is characterized by epiphyseal stippling and midfacial hypoplasia. CDP is usually inherited, but can be acquired because of maternal vitamin K deficiency. We describe an infant with CDP born to a teenager with sickle cell anemia and transfusional iron overload. The mother had severe liver fibrosis, elevated liver iron concentration (34 mg Fe/g), and coagulopathy, but no gestational use of warfarin. Fetal abnormalities were attributed to vitamin K deficiency secondary to liver dysfunction from iron toxicity. Treatment of iron overload among women with sickle cell anemia of childbearing potential is important to avoid possible CDP in newborns.

show abstract

Deferoxamine treatment during pregnancy: Is it harmful?

Cited by 64 publications

References 14 publications

Pregnancy and -thalassemia: an Italian multicenter experience

Pregnancy and -thalassemia: an Italian multicenter experience

Chelators as Antidotes of Metal Toxicity: Therapeutic and Experimental Aspects

Phenocopy of Warfarin Syndrome in an Infant Born to a Mother With Sickle Cell Anemia and Severe Transfusional Iron Overload

Contact Info

Product

Resources

About