Elevated total iron-binding capacity as a predictor of response to deferasirox therapy in the setting of chronic iron overload

It is difficult to predict the efficacy of deferasirox (DFX) as its pharmacokinetics varies among patients. The area under the curve (AUC) is reportedly useful for determining adequate DFX dosage; however, serum concentration measurements are often challenging. Effective DFX dosage is thus defined b...

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Bibliographic Details
Published in:International journal of hematology 2014-09, Vol.100 (3), p.254-259
Main Authors: Watanabe, Junichi, Sato, Ken, Horiuchi, Toshikatsu, Kato, Shoichiro, Hikota, Reina, Maekawa, Takaaki, Yamamura, Takeshi, Kobayashi, Ayako, Osawa, Yukiko, Kobayashi, Shinichi, Kimura, Fumihiko
Format: Article
Language:English
Subjects:
Benzoates - therapeutic use
Biological and medical sciences
Blood Proteins - metabolism
Drug Monitoring
Female
Ferritins - blood
Hematologic and hematopoietic diseases
Hematologic Neoplasms - blood
Hematologic Neoplasms - pathology
Hematologic Neoplasms - therapy
Hematology
Humans
Iron - blood
Iron Chelating Agents - therapeutic use
Iron Overload - blood
Iron Overload - drug therapy
Iron Overload - etiology
Iron Overload - pathology
Male
Medical sciences
Medicine
Medicine & Public Health
Metabolic diseases
Metals (hemochromatosis...)
Middle Aged
Multivariate Analysis
Oncology
Original Article
Other metabolic disorders
Prognosis
Protein Binding
Retrospective Studies
ROC Curve
Transfusion Reaction
Treatment Outcome
Triazoles - therapeutic use
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Summary:It is difficult to predict the efficacy of deferasirox (DFX) as its pharmacokinetics varies among patients. The area under the curve (AUC) is reportedly useful for determining adequate DFX dosage; however, serum concentration measurements are often challenging. Effective DFX dosage is thus defined by assessing the efficacy of this agent in clinical practice. To analyze a predictive response marker to DFX therapy for use in adjusting the effective dosage during the early treatment phase, we retrospectively evaluated 39 DFX-treated patients. We defined response as a >40 % decrease in serum ferritin concentration from the pretreatment level. A maximum elevation of the total iron-binding capacity (TIBC) correlated with response in a multivariate analysis of iron metabolic markers ( R 2  = 0.37, p  
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-014-1624-9