As iron continues to build up in the body, complications happen more often
Comparing sickle cell disease patients with iron overload‡ to those without iron overload, a review of clinical trials in 2018 showed that sickle cell patients with iron overload had higher rates of:
Mortality(64% vs. 5%)
Organ failure(71% vs. 19%)
Pain episodes(64% vs. 38%)
§Defined as serum ferritin levels >1,500 ng/mL and transferrin saturation >50%.
Monitor renal toxicity
Kidney complications are common in patients with sickle cell disease – affecting 30-50% of adults. Regular monitoring of both renal and hepatic toxicity can help optimize chelation and ensure patients are on an appropriate chelator.
The only way to know if your patients' iron chelator is working is to have their iron levels checked regularly
Iron chelation needs to be adjusted regularly or even switched depending on iron level, weight, and tolerance to side effects
|Sickle Cell Disease treatment guidelines support regular monitoring of serum ferritin, and cardiac and liver MRI T2*|
|Parameter||Target||Expert panel recommendation|
|Serum ferritin||25-300 ng/mL||Monthly|
|Liver iron concentration (LIC)||800-3,500 µg/g dry weight||Every 1-2 years|
|Cardiac MRI T2*||>20 ms||Performed for patients with: