演題詳細

ポスター / Poster

ポスター 3 (Poster 3) :鉄キレート療法 (Iron Chelate Therapy)

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
藤島 眞澄 (Masumi Fujishima):1
1:秋田大学医学部 血液・腎臓・膠原病内科学
 
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Usefullness of deferoxamine continuous subcutaneous home infusion in case of allergy to deferosirox

演題番号 : PS-1-17

沖本 由理 (Yuri Okimoto):1、種山 雄一 (Yuichi Taneyama):1、市川 大輔 (Daisuke Ichikawa):1、角田 治美 (Harumi Kakuda):1

1:Div. Hematology/Oncology Chiba Children's Hospital,Japan

 

Deferoximine continuous subcutaneous infusion(CSI) is well known to have successful decrease of serum ferritin and red blood cell transfusions in the transfusion dependent various diseases. However in Japan deferoxiamine is to be given only by intramuscular or intravenous injection. In these days deferosirox seems to be the first choice for iron over load condition, but there are some patients who have allergic reactions to the drug. We are caring a 25 year old woman with transfusion dependent severe aplastic anemia(AA) and allergy to deferosirox. She suffered from moderate AA at 7 years old, afterthat her disease marched to severe AA. She was given cyclosporine and horse ATG in 1995, and then rabbit ATG in 1997 without any effect. No suitable donor was found for SCT because of her rare HLA type. After getting permission by our hospital ethical inspection committee, home CSI with 500mg deferoxiamine in 1ml distilled water for 8 hours started from 2000 when her ferritin reached 4000ng/ml. Her compliance was poor in those years. Her serum ferritin remained 4000-6000ng/ml for many years. She joined clinical trial of deferosirox and learned much about the importance of avoid iron over loud at 2008. Unfortunately she presented severe allergic reaction with fever rash and edema. The CSI of deferoxamine restarted in good compliance. Her serum ferritin gradually decreased from 4800ng/ml at 2008 to 1800ng/ml at 2013. Red blood cell transfusion decreased 27 times in 2008 to 11 times in 2012. The deferoxamine home CSI should be covered by the Japanese health insurance system.

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