Chelation therapy in liver diseases of childhood: Current status and response

Table 4 Properties of iron-chelators

Properties	Deferoxamine (DFO)	Deferasirox (DFX)	Deferiprone (DFP)
Chelator: Iron ratio	1:1	2:1	3:1
Plasma t1/2	30 min	12-16 h	2-3 h
Usual dose	20-50 mg/kg per day over 8-24 h	20-40 mg/kg per day once daily	75-100 mg/kg per day in 3 divided doses
Route of administration	Subcutaneous, intravenous	Oral	Oral
Clearance	Renal, hepatic	Hepatic	Renal
Efficacy in removing liver iron stores	Good	Good	Moderate
Efficacy in removing cardiac iron	Moderate	Moderate	Good
Advantages	Long safety data available, strongest chelator on molar basis	Oral once daily dose is sufficient	Oral, effective in removing cardiac iron
Adverse effects	Local reactions	Gastric intolerance	Nausea
	Sensorineural hearing loss	Rash	Vomiting
	Bone abnormalities	Diarrhea	Diarrhea
	Retinopathy	Elevation in creatinine	Arthralgia
	Pulmonary disease	Elevation in transaminases	Elevated liver enzymes
	Allergic reaction	Peptic ulcer	Agranulocytosis
	Bacterial infections (e.g., Listeria, Klebsiella)	Renal dysfunction
		Hepatic dysfunction