Iron Chelation

What is iron chelation therapy?

Children whose medical condition requires regular red blood cell transfusions can develop iron overload, meaning there is too much iron in the body. Red blood cells contain iron, so each time your child receives a red blood cell transfusion more iron is going into their body. Without a way to get rid of the extra iron, it build ups in the internal organs, such as the liver, pancreas, heart and endocrine glands, and can damage them over time.

Iron overload is treated with the use of iron chelation drugs. There are two iron chelators currently available and approved by the U.S. Food and Drug Administration (FDA):

  • Deferoxamine (Desferal®), given subcutaneously (under the skin)
  • Deferasirox (Exjade® or Jadenu®) a once-daily oral chelator, available as a dispersible or film-coated tablet 

One additional iron chelator, not yet approved by the FDA, is currently being used in Europe, Asia, and Canada.

What are the side effects of iron chelators?

Common side effects of iron chelators may include:

  • impaired or blurred vision
  • rash or hives
  • itching
  • vomiting
  • diarrhea
  • stomach or leg cramps
  • rapid heart beat
  • hypotension (low blood pressure)
  • dizziness

Once the body gets used to the drug, side effects usually go away. A doctor should monitor your child's liver and kidneys for more serious side effects.

How we approach iron chelation therapy

Our Blood Disorder Center performs thousands of blood transfusions each year, and has expertise in treating iron overload, the leading side effect of chronic blood transfusions. We also provide transfusional iron overload evaluations to ensure that children receive the most effective and appropriate transfusion and iron chelation regimens over time. Our experts tailor iron chelation strategies from the drugs currently available and approved, and we participate in research studies of novel chelation agents to bring better choices to our patients in the future.