Dual Oral Iron Chelation (DOIC) in Children with Transfusion-Dependent Beta Thalassemia: Real-World Efficacy Data

Combination chelation with deferiprone (DFP) and deferasirox (DFX) is one of the treatment modalities for iron overload in children with Transfusion-dependent Thalassemia (TDT). We report our experience with dual oral iron chelation. Retrospective chart review was conducted on all children started on Dual Oral Iron Chelation (DOIC) from 2015 to 2022. Children with TDT requiring DOIC were included in the study. Forty-five children required DOIC. The mean SF before DOIC initiation was 2929 ng/dl (SD 1465.07). The mean ferritin following DOIC was 1962.10 ng/dl (SD 1165.83) at 30 months. Mean duration on DOIC was 44.6 months (IQR 60–30). With DOIC, 82.22% children had a fall in ferritin to < 2000 ng/dl and in 60% of them had fall to < 1000 ng/dL. Dual Oral Iron Chelation (DOIC) is efficacious in reducing ferritin in iron-overloaded patients. Higher ferritin values (> 2500 ng/dL) drop rapidly in the first 12–24 months. DOIC was well-tolerated with no severe adverse effects.