Department of Pediatric Hematology, School of Medicine, Ege University, Izmir, Turkey.
Ann N Y Acad Sci. 2023 Nov;1529(1):33-41. doi: 10.1111/nyas.15052. Epub 2023 Aug 18.
Combination chelation therapies are considered in transfusion-dependent thalassemia patients for whom monotherapy regimens have failed to achieve iron balance or intensification of iron chelation therapy is required for the rapid reduction of excess iron to avoid permanent organ damage. Combination chelation may provide a more flexible approach for individualizing chelation therapy, thereby improving tolerability, adherence, and quality of life. In principle, iron chelators can be combined with an infinite number of dosing regimens; these involve simultaneous or sequential exposure to the chelators on the same day or alternating the drugs on different days. Clinical studies have established the safety and efficacy of chelation combinations. However, real-life data with combination therapies indicate the significance of compliance for a meaningful reduction in iron overload compared to monotherapies.
联合螯合疗法适用于依赖输血的地中海贫血患者，对于那些单一疗法方案未能达到铁平衡或需要强化铁螯合治疗以快速减少多余铁以避免永久性器官损伤的患者。联合螯合可能为个体化螯合治疗提供更灵活的方法，从而提高耐受性、依从性和生活质量。原则上，铁螯合剂可以与无数种剂量方案联合使用；这些方案涉及同一天同时或顺序暴露于螯合剂，或在不同天交替使用药物。临床研究已经证实了螯合组合的安全性和有效性。然而，联合治疗的实际数据表明，与单一疗法相比，依从性对于显著减少铁过载具有重要意义。
