A novel delivery system for continuous desferrioxamine infusion in transfusional iron overload

Fifteen iron-overloaded thalassaemia major (TM) patients and two homozygous sickle cell patients (SCD) were treated continuously for 7 d each week with the novel 48 h continuous subcutaneous (s.c.) desferrioxamine (DFX) delivery device (code C1083, Baxter) and 10 TM patients received the 24 h continuous intravenous (i.v.) DFX delivery device (code C1071). The 27 patients had previously received conventional s.c. DFX for 8-10 h on 5 or more days each week. The serum non-transferrin bound iron (NTBI) levels fell significantly in both groups within 12 h of commencing the continuous infusion. In the s.c. group the mean level fell from 4.2 to 2.0 mu mol/l (P = 0.001), whereas in the i.v. group the mean level fell from 3.6 to 0.1 mu mol/l (P = 0.006) the initial levels being measured 12 h after stopping conventional s.c. DFX. After 4 weeks there was a significant fall in serum ferritin in both groups (P = 0.009). The new DFX delivery device is effective at removing toxic-free iron from plasma and reducing body iron. Moreover, it is preferred by patients with much improved compliance compared to the conventional s.c. DFX pump.