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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Impact of cyclosporine A on renal function under the combined use of deferasirox

演題番号 : PS-1-18

坂本 竜弘 (Tatsuhiro Sakamoto):1、小原 直 (Naoshi Obara):1、関 正則 (Masanori Seki):1、栗田 尚樹 (Naoki Kurita):1、横山 泰久 (Yasuhisa Yokoyama):1、坂田 麻実子 (Mamiko Sakata):1、鈴川 和己 (Kazumi Suzukawa):1、長谷川 雄一 (Yuichi Hasegawa):1、千葉 滋 (Shigeru Chiba):1

1:Department of Clinical and Experimental Hematology

 

[Background] Deferasirox (DFX), an iron chelator, has considerably improved the management of iron overload, which is caused by repeated transfusion of red blood cells for patients with bone marrow failure syndrome such as aplastic anemia (AA). Among side effects of DFX, renal toxicity is among the most important and sometimes precludes the efficient iron chelating treatment. Cyclosporin A (CsA) is the mainstay of immunosuppressive therapy for AA. Because renal toxicity is also common in CsA, combinatorial use of CsA and DFX is sometimes problematic. In this study, we analyzed the effect of DFX on renal function under the use of CsA. [Patients /Method] Eleven cases prescribed with DFX in combination with CsA at the University of Tsukuba Hospital from Jan 2009 to Feb 2013 were compared with 36 cases with DFX alone in the same period. Renal dysfunction was defined as a 33 % increase of serum creatinine over baseline. [Result] We found that 7 out of 11 (63.6%) and 6 out of 36 (16.7%) patients had a renal dysfunction in the DFX/CsA and DFX alone cohort, respectively. The renal dysfunction was reversible in all the patients in whom the DFX was discontinued. Combinatorial treatment with DFX and CsA was possible in 5 out of 6 patients showing renal dysfunction in the DFX/CsA cohort by reducing DFX. [Conclusion] The combination of DFX and CsA increases the risk of renal dysfunction. Simultaneous use of both drugs may be possible in most cases by the adjustment of dosage of DFX. The effect of such a dose modification on iron overload needs to be studied.

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