Iron chelation in 1998

Chronic transfusion regimens lead inevitably to iron overload, causing progressive organ dysfunctions and limiting life expectancy, so that iron chelation is needed in multiple-transfused patients to reduce iron accumulation and toxicity. Desferal(R) is still the most used and the most efficacious chelator. It must be, however, administered through subcutaneous infusion over 8-12 hours. Difficulties with compliance have prompted an ongoing search for alternatives, and in particular for molecules active after oral administration. The only drug available today is L1. This drug is less active than Desferal(R), and is responsible for rare agranulocytosis. Its indications are still to be discussed. (C) 1998 Elsevier, Paris.