The Proceedings Of The 19Th International Conference On Chelation Held In London, United Kingdom: Major Changes In Iron Chelation Therapy In The Last 25 Years Using Deferiprone (L1) Has Resulted In The Complete Treatment Of Iron Overload

Abstract

Major advances were presented at the 19th International Conference on Chelation (ICOC) in London, UK including changes in iron chelation therapy that led to the complete treatment of transfusional iron overload. The first oral iron chelation results in animals using deferiprone (L1) were published in 1985, and effective iron removal in thalassemia and myelodysplasia patients were reported 2 years later. The results of multicenter clinical trials of L1 were presented at the 1st ICOC in London, UK in 1989. Long-term use of L1 resulted in the reduction of the mortality rate in thalassemia patients due to the effective removal of all excess iron from the heart. In 2008, specific combinations of L1 and deferoxamine (DFO) were reported to cause the complete removal of excess iron load and the achievement of normal range body iron store levels (NRBISL) in thalassemia patients. Patients with NRBISL were identified to require lower doses of L1 for the maintenance of negative iron balance. The introduction of deferasirox (DFRA) may benefit patients not tolerating L1, DFO or their combination. A simple, inexpensive synthesis of L1 has encouraged its manufacture in developing countries for the benefit of patients who could not afford the expensive imported chelating drugs or formulations.

• Iron (Fe)
• Iron overload
• Chelation
• Thalassemia
• Deferiprone (L1)
• Deferoxamine (DFO)
• Deferasirox (DFRA)

ACKNOWLEDGMENTS

I would like to thank the authors and reviewers involved in the production of the 19th ICOC proceedings, the members of the ICOC and other scientific committees, the United Kingdom Thalassaemia Society for sponsoring the conference, the participants and all others who contributed to the successful organization of the 19th ICOC in London, UK, in November 2009.

Declaration of Interest: The author reports no conflicts of interest. The authors alone are responsible for the content and writing of this article.