PURPOSE: The clinical outcomes of an institution's critical pathway that uses a comprehensive approach to serum ferritin management are reported. The results of this center are compared with the results of a national survey of deferoxamine (DFO) use and serum ferritin level outcomes. METHODS: Current DFO dosing and serum ferritin levels of 38 patients at this center were summarized. A questionnaire was then sent to 98 centers throughout the United States requesting information on criteria for beginning treatment with DFO, administration methods, dose modifications, and serum ferritin levels. RESULTS: The application of a critical pathway in this program resulted in 29 of 38 patients maintaining serum ferritin levels <2,000 ng/mL. Of the 42 institutions that responded to the survey, 10 attained this ferritin level in > or =50% of their patients. Ferritin levels ranged from 500 ng/mL to >20,000 ng/mL, and wide variations were reported in all study parameters. CONCLUSIONS: Iron overload can be effectively managed with alteration of DFO doses and routes using a consistent approach. Modification of administration methods, including administration of DFO during red blood cell transfusions, are indicated to attain ferritin levels of <2,000 ng/mL.
PURPOSE: The clinical outcomes of an institution's critical pathway that uses a comprehensive approach to serum ferritin management are reported. The results of this center are compared with the results of a national survey of deferoxamine (DFO) use and serum ferritin level outcomes. METHODS: Current DFO dosing and serum ferritin levels of 38 patients at this center were summarized. A questionnaire was then sent to 98 centers throughout the United States requesting information on criteria for beginning treatment with DFO, administration methods, dose modifications, and serum ferritin levels. RESULTS: The application of a critical pathway in this program resulted in 29 of 38 patients maintaining serum ferritin levels <2,000 ng/mL. Of the 42 institutions that responded to the survey, 10 attained this ferritin level in > or =50% of their patients. Ferritin levels ranged from 500 ng/mL to >20,000 ng/mL, and wide variations were reported in all study parameters. CONCLUSIONS:Iron overload can be effectively managed with alteration of DFO doses and routes using a consistent approach. Modification of administration methods, including administration of DFO during red blood cell transfusions, are indicated to attain ferritin levels of <2,000 ng/mL.
Authors: Thomas E Delea; Oleg Sofrygin; Simu K Thomas; Jean-Francois Baladi; Pradyumna D Phatak; Thomas D Coates Journal: Pharmacoeconomics Date: 2007 Impact factor: 4.981