MANAGEMENT OF TRANSFUSIONAL IRON OVERLOAD

• Sueoka Eisaburo

  Department of Internal Medicine, Faculty of Medicine, Saga University Department of Transfusion Medicine, Saga University Hospital

• Yamada Naotomo

  Department of Transfusion Medicine, Saga University Hospital

• Yamada Marie

  Department of Transfusion Medicine, Saga University Hospital

• Kubota Yasushi

  Department of Internal Medicine, Faculty of Medicine, Saga University Department of Transfusion Medicine, Saga University Hospital

• Urata Chisako

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Yoshimura Mariko

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Itamura Hidekazu

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Hisatomi Takashi

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Fukushima Noriyasu

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Ide Masaru

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Yokoo Masako

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Yoshihara Mari

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Kamachi Kazuharu

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Kitamura Hiroaki

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Shindo Takero

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Ichinohe Tatsuo

  Department of Internal Medicine, Faculty of Medicine, Saga University

• Higashitani Takanori

  Department of Transfusion Medicine, Saga University Hospital

• Kimura Shinya

  Department of Internal Medicine, Faculty of Medicine, Saga University

Bibliographic Information

Other Title

• 輸血後鉄過剰症の現状と問題点

Abstract

Frequent blood transfusion causes iron overload and leads to failure of various organs in patients with anemia related to chronic hematopoietic dysfunction, such as aplastic anemia and myelodysplastic syndrome. Deferasirox (DFX), an oral iron chelating agent, was recently developed, and has resulted in improvements in iron chelation therapy compliance with medication and in overall survival in patients with transfusional iron overload. In addition, medical guidelines for the treatment of transfusional iron overload were promulgated after July 2008, providing criteria for the diagnosis of transfusional iron overload and iron chelation therapy.<br> We assessed compliance with iron chelation therapy according to the guidelines for treatment of transfusional iron overload during the five-year period from January 2007 to December 2011 at Saga University Hospital. Four hundred and nineteen patients who received over 20 units of total erythrocyte transfusion annually were enrolled in this study. Patients' serum ferritin values measured at least once during the period in the patients in hematological and pediatric patients out of proportion was 28%, 45%, 71%, 66% and 72% respectively, toward the 2011 from 2007. Also, average serum ferritin value measured at the first time exceeded 2,500ng/ml and total red blood cells transfusion of average was more than 40 units up to half. Fifteen people received chelation therapy with DFX during the study period, and only four patients received chelation therapy according to the medical guideline for transfusional iron overload.<br> These results indicate that management of transfusional iron overload in our Hospital is insufficient, probably due to the difficulty in precisely understanding the total units of erythrocytes transfused to patients and the delay in recognition of the status of iron overload. In this regard, a new component of the electronic medical record system in our hospital has been developed to support clinicians seeking support with transfusion management.<br>

Journal

• Japanese Journal of Transfusion and Cell Therapy

  Japanese Journal of Transfusion and Cell Therapy 59 (1), 73-78, 2013

  The Japan Society of Transfusion Medicine and Cell Therapy

Keywords

• Chronic hematopoietic dysfunction
• Transfusional iron overload
• Iron chelation therapy
• Total units of red blood cell transfusion
• Deferasirox

Details

• CRID: 1390001205273323392
• NII Article ID: 10031165492
• NII Book ID: AA12159645
• DOI: 10.3925/jjtc.59.73
• ISSN: 18830625
• ISSN: 18813011
• Web Site: https://search.jamas.or.jp/link/ui/2013219118
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed