Long-term administration of high-dose deferoxamine 2 days per week in thalassemic patients

: Objective: Compliance with parenteral administration of deferoxamine is often poor in thalassemic patients with iron overload. We tested the efficacy and tolerance of the drug at high dosage 2 d per week for 24 months in two adult thalassemic patients with permanently high serum ferritin using a portable pump and an implanted chamber. Methods: Deferoxamine was administered using a pressure‐operated portable pump through an implanted chamber. The patients were infused over 48 h every week with 198 mg/kg/d (patient 1) and 170 mg/kg/d (patient 2). Serum ferritin levels were measured at regular intervals. Results: Serum ferritin decreased progressively from 2967 to 457 µg/L in patient 1 and from 6476 to 1951 µg/L in patient 2. Compliance and tolerance to treatment were excellent in the two patients. Conclusion: Intravenous administration of high‐dose deferoxamine over 48 h per week using a portable pump and implanted chamber improved compliance in two thalassemic adult patients, resulting in a significant decrease in iron overload. We suggest that high‐dose chelation therapy should be assessed in selected groups of iron‐overload thalassemic patients receiving regular blood transfusions.