Deferoxamine for the Treatment of Hemochromatosis

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ClinicalTrials.gov Identifier: NCT00001203

Recruitment Status : Completed

First Posted : November 4, 1999

Last Update Posted : December 12, 2019

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Sponsor:

Information provided by (Responsible Party):

National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) )

Study Description

Brief Summary:

When patients receive repeated blood transfusions the level of iron in the patient s blood can rise. When iron is processed in the body a protein known as hemosiderin can begin collecting in the organs. If too much hemosiderin collects in the organs they can begin to malfunction. This condition is called transfusional hemochromatosis.

An organ of particular importance in transfusional hemochromatosis is the heart. Patients born with diseases requiring blood transfusions at birth begin to develop heart problems in their teens. These patients typically only live for 17 years. Adults that require transfusions can begin experiencing heart problems after 100-200 units of backed red blood cells.

Deferoxamine (Desferal) is a drug that binds to iron and allows it to be excreted from the body. It is the only effective way to remove iron from patients who have been overloaded with iron because of multiple transfusions. Previous studies have lead researchers to believe that deferoxamine, when given as an injection under the skin (subcutaneous), can be delay or prevent heart complications.

Researchers plan to continue studying patients receiving deferoxamine as treatment for the prevention of heart complications associated with repeated blood transfusions. In this study researchers will attempt;

To determine if deferoxamine, given regularly, can indefinitely prevent the heart, liver, and endocrine complications associated with transfusional hemochromatosis
To determine whether heart disease caused by transfusional hemochromatosis can be reversed by intensive treatment with deferoxamine.

Condition or disease
Diabetes Mellitus Heart Disease Hemochromatosis Thalassemia

Detailed Description:

The purposes of this protocol are two-fold: 1) to determine whether deferoxamine, given subcutaneously on a regular basis, can indefinitely prevent the cardiac, endocrine and hepatic complications of transfusional hemochromatosis; and 2) to determine whether cardiac disease can be reversed by intensive intravenous treatment in patients who already have objective evidence of cardiac dysfunction. The clinical manifestations and course of patients who require regular blood transfusions is well established. Those with congenital anemias who require transfusions from birth develop cardiac disease in their teens and their mean of survival is only 17 years. Adults with acquired anemias begin to exhibit cardiac manifestations of iron deposition after 100-200 units of packed red cells. Deferoxamine, when given by the subcutaneous route, has been shown to reduce substantially the total iron burden in thalassemic patients. Our results indicate that cardiac complications are delayed or prevented. We plan to continue to follow our cohort of patients on optimal medical management to determine if chelation alters disease outcome. Patients with heavy iron burdens who already manifest cardiac disease will be chelated intensely to determine whether reducing the iron burden is associated with reversal of cardiac complications.

Study Design

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Study Type :	Observational
Actual Enrollment :	151 participants
Official Title:	Clinical Course of Patients With Transfusional Hemochromatosis on Deferoxamine
Study Start Date :	April 22, 1985
Study Completion Date :	November 9, 2015

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Hereditary hemochromatosis

MedlinePlus related topics: Hemochromatosis

Drug Information available for: Deferoxamine

Genetic and Rare Diseases Information Center resources: Thalassemia Hemochromatosis Type 3 Hemosiderosis

U.S. FDA Resources

Groups and Cohorts

Outcome Measures

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:	4 Years and older (Child, Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

INCLUSION CRITERIA

Patients studied under this protocol will be at risk for or have evidence of significant excess tissue iron.

Most patients will be on regular blood transfusion secondary to either congenital or acquired anemia.

The majority of patients have homozygous beta thalassemia.

Patients with sickle cell anemia will be included only when there is an absolute indication for regular blood transfusions (e.g., a history of stroke).

Twenty to thirty adults with acquired anemia and good long-term prognosis will be accepted for study if chelation can be initiated early in their transfusion history (less than 30-50 units).

EXCLUSION CRITERIA

Such patients will be excluded from study if they have diabetes or cardiac disease due to another cause (coronary artery or valvular heart disease).

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00001203

Locations

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United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892

Sponsors and Collaborators

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

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Principal Investigator:	Griffin P Rodgers, M.D.	National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

More Information

Publications:

Lucarelli G, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Politi P, Durazzi SM, Muretto P, Albertini F. Bone marrow transplantation in patients with thalassemia. N Engl J Med. 1990 Feb 15;322(7):417-21. doi: 10.1056/NEJM199002153220701.

Ley TJ, DeSimone J, Anagnou NP, Keller GH, Humphries RK, Turner PH, Young NS, Keller P, Nienhuis AW. 5-azacytidine selectively increases gamma-globin synthesis in a patient with beta+ thalassemia. N Engl J Med. 1982 Dec 9;307(24):1469-75. doi: 10.1056/NEJM198212093072401.

Brittenham GM, Farrell DE, Harris JW, Feldman ES, Danish EH, Muir WA, Tripp JH, Bellon EM. Magnetic-susceptibility measurement of human iron stores. N Engl J Med. 1982 Dec 30;307(27):1671-5. doi: 10.1056/NEJM198212303072703.

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Responsible Party:	National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier:	NCT00001203
Other Study ID Numbers:	850087 85-H-0087
First Posted:	November 4, 1999 Key Record Dates
Last Update Posted:	December 12, 2019
Last Verified:	November 9, 2015

Keywords provided by National Institutes of Health Clinical Center (CC) ( National Heart, Lung, and Blood Institute (NHLBI) ):


Desferal Thalassemia Liver Iron Concentration Endocrine Evaluation	Diabetes Mellitus Cardiac Disease Acquired Anemia

Additional relevant MeSH terms:

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Heart Diseases Thalassemia Hemochromatosis Diabetes Mellitus Hemosiderosis Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Cardiovascular Diseases Anemia, Hemolytic, Congenital	Anemia, Hemolytic Anemia Hematologic Diseases Hemoglobinopathies Genetic Diseases, Inborn Metal Metabolism, Inborn Errors Metabolism, Inborn Errors Iron Overload Iron Metabolism Disorders

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