去铁治疗病例分享.pptVIP

去铁胺 去铁酮 地拉罗司 地拉罗司使MDS患者异常的血浆铁含量降至正常 *基线LPI和每个治疗时间点的对比 LPI，异常血浆铁 1.List AF, et al.J Clin Oncol 2012;30:2134–9 2.Gattermann N, et al.Leuk Res.2010;34:1143-50. 给药前 给药后 0 0.2 0.4 0.6 0.8 1.0 1.2 平均LPI ? SD (μmol/L) 基线 12 28 52 时间（周） 正常阈值 患者，n 55 38 39 37 34 基线LPI ≥0.5 μmol/L的患者比例 = 41% 正常LPI的阈值 (≤0.5 μmol/L) 平均LPI (μmol/L) 0 0.2 0.4 0.6 0.8 1.0 1.2 基线 3 6 9 12 距离基线的月数 P?0.00001* US03 研究1 EPIC研究-MDS队列2 研究US02 * * * * Bottom line different colour Malcovati et al. [22] have shown, using Cox proportional hazards models, that OS is adversely affected by secondary iron overload developed after having received a median number of 21 RBC units (HR 1.36 per 500 ng/ml increase in serum ferritin 1000 ng/ml; p 0.001).When including the number of RBC units received per month into these models, the adverse effect of iron overload on OS was preserved (HR 1.30; p = 0.003). * * * The safety profile of deferasirox has been well characterized, and most adverse events associated with deferasirox are manageable.The primary adverse events are GI disturbances, including diarrhoea, nausea vomiting, and abdominal pain.1 It has been noted that GI disturbances are the main cause of discontinuation of deferasirox treatment.2 Prompt and effective management of these adverse events may reduce the need for treatment discontinuation, allowing more patients to continue to receive iron chelation therapy. References Gattermann N, et al.Deferasirox in iron-overloaded patients with transfusion-dependent myelodysplastic syndromes: results from the large 1-year EPIC study.Leuk Res.2010;34:1143-50. Nolte F, et al.Clinical management of gastrointestinal disturbances in patients with myelodysplastic syndromes receiving iron chelation treatment with deferasirox.Leuk Res.2011;35:1131-5. Abbreviations GI = gastrointestinal MDS = myelodysplastic syndromes * In the clinical evaluation of deferasirox, gastrointestinal disturbances were seen to be generally mild-to-moderate in severity, tended to occur early