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Multidisciplinary evaluation at baseline and during treatment improves the rate of compliance and efficacy of deferasirox in elderly myelodysplastic patients

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Abstract

Background

Deferasirox (DFX) is used to reduce iron levels in patients with myelodysplastic syndrome (MDS) who develop iron overload after chronic red blood cell infusions. However, DFX can be associated with renal and gastrointestinal toxicities, which may cause treatment interruption or discontinuation. This study aimed to determine the effectiveness and safety of DFX in patients with MDS.

Methods

This multicenter, retrospective, observational study was conducted at two hospitals in Italy. Elderly patients with transfusion-dependent MDS received DFX for up to 12 months and were divided into two groups: group A comprised patients who were not under multidisciplinary assessment; group B comprised patients under multidisciplinary control. Treatment effectiveness was estimated by monitoring the serum ferritin (SF) levels throughout the study. Any treatment-related adverse events (AEs), clinically relevant analytical alterations, and reasons for treatment discontinuation were monitored.

Results

The study included 44 patients (13 female, 31 male; median age 77.0 years). At 3 months, SF levels decreased by ≥20 % in 29 and 31 % of patients in groups A and B, respectively, in 17 and 36 % of patients at 6 months, and in 22 and 58 % at 12 months. The most common AEs were diarrhea and increased serum creatinine, which were more frequent in group A. The discontinuation rate after renal AE was 15 and 5 % in groups A and B, respectively.

Conclusion

Multidisciplinary evaluation can be an effective strategy for monitoring renal function in patients on DFX therapy, to improve treatment adherence and overall efficacy in elderly patients with MDS.

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Acknowledgments

The authors thank Nishad Parkar, PhD, of Springer Healthcare Communications for providing technical and English editing of the manuscript. This medical writing assistance was funded by Novartis, Italy.

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Authors and Affiliations

  1. Internal Medicine, Department of Hematology and Oncology, IRCCS AOU San Martino-IST, Largo R. Benzi, 10, 16132, Genoa, Italy

    Lisette Del Corso & Eleonora Arboscello

  2. Blood Bank, Department of Health Management, AOU City Health Presidium Molinette, Corso Bramante 88, 10126, Turin, Italy

    Lucia Biale

  3. Nephrology, Department of Internal Medicine and Medical Specialties, IRCCS AOU San Martino-IST, Largo R. Benzi, 10, 16132, Genoa, Italy

    Emanuele Luigi Parodi & Rodolfo Russo

  4. Clinical Epidemiology, IRCCS AOU San Martino-IST, Largo R. Benzi, 10, 16132, Genoa, Italy

    Rosa Filiberti

Authors
  1. Lisette Del Corso
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  2. Lucia Biale
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  3. Emanuele Luigi Parodi
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  4. Rodolfo Russo
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Corresponding author

Correspondence to Eleonora Arboscello.

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Conflict of interest

LDC, LB, ELP, RR, and RF disclosed no conflict of interest. EA received honoraria from Ariad, Celgene, and Novartis for participating in round tables and writing congress reports.

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Del Corso, L., Biale, L., Parodi, E.L. et al. Multidisciplinary evaluation at baseline and during treatment improves the rate of compliance and efficacy of deferasirox in elderly myelodysplastic patients. Int J Clin Oncol 22, 380–386 (2017). https://doi.org/10.1007/s10147-016-1042-5

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  • DOI: https://doi.org/10.1007/s10147-016-1042-5

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