Protocols - Hemorio

MONITORING AND ADVERSE EFFECTS (Cont’)
SPECIFIC MONITORING
− Yearly audiometry
− Yearly ophthalmologic test
− Yearly FO
ADVERSE EFFECTS
Desferrioxamine
(DFO)
− Height and weight in a sitting position every
6 months (estadiometer of Harpenden)
− Yearly bone densitometry > 10 years old
− Interrupt the usage during pregnancy (in
cases of severe overload, return on the 3rd quarter)
− RX of the long bones and the spine yearly
− Toxicity index every 6m
− ALT / AST 4/4 m
− Urea monthly
− Creatinine 2X before the onset of TTO
− Allergy
− Auditive disorders
− Visual disorders
− Bone injuries similar to raquitism
Deferasirox
Exjade (DFX)
1st month – weekly
Maintenance – monthly
− Opht. exam – onset of the TTO + yearly
− Ferritin – monthly
− Hepatic function prove – monthly
− Hemogram – monthly
− Proteinuria - monthly
− GI (nauseas, vomits)
− Dermatologic
− Renal (↑creatinine)
Deferiprone
Ferriprox (DFP)
− Hemogram weekly
− ALT / AST 4/4 m
− Urea and creatinine yearly
Temporary discontinuation: Neutr < 1,500
> 500/mm3 Definitive Discontinuation: Neutr <
500/mm3 Combination
DFO + DFP - Relapse of neutropenia after the
reintroduction
- Introduce G-CSF if neutropenia > 72h /
infection.
− GI (nauseas, vomits)
− Hepatotoxicity
− Leuko and neutropenia
− Arthropatias
(*) Serum creatinine monthly: If there is any increase in children below 15 years old of more than 33% of
the low limit the dose must be reduced in steps of 5 mg/kg/day. Above 15 years old, you must consider an
increase when it is 33% above the baseline creatinine values. Remember that there must be two
consecutive measures at the interval of a month.
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