Evaluation and treatment of transfusional iron overload in children

Pediatr Clin North Am. 2013 Dec;60(6):1393-406. doi: 10.1016/j.pcl.2013.09.003.

Abstract

Red blood cell transfusions are increasingly used in the management of various anemias, including thalassemia and sickle cell disease. Because the body lacks physiologic mechanisms for removing excess iron, transfusional iron overload is a common complication in children receiving regular transfusions. Iron chelation is necessary to remove the excess iron that causes injury to the heart, liver, and endocrine organs. Three chelators, deferoxamine, deferasirox, and deferiprone, are currently available in the United States. When choosing a chelator regimen, patients, parents, and providers may consider a variety of factors, including the severity of iron overload, administration schedule, and adverse effect profile.

Keywords: Chelation; Iron overload; Magnetic resonance imaging; Transfusion.

Publication types

  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Erythrocyte Transfusion / adverse effects*
  • Humans
  • Iron / blood*
  • Iron Chelating Agents / adverse effects
  • Iron Chelating Agents / therapeutic use*
  • Iron Overload / diagnosis*
  • Iron Overload / drug therapy*
  • Iron Overload / etiology

Substances

  • Iron Chelating Agents
  • Iron