Page 132 - Haematologica March 2020

M. Hoeks et al.
Impact of iron chelation therapy on hematopoiesis and ferritin levels
Figure 5 shows the changes in transfusion density over eight visits in chelated and non-chelated patients. Forty- eight (62.3%) of the 77 responding patients were treated with ESA and 16 (20.8%) were treated with lenalidomide during chelation therapy. Compared to first check-up, 61 of the 197 chelated patients (31.0%) had a reduction in transfusion density, i.e. an absolute decrease, during at least one interval between check-ups, two patients (1.0%) maintained the same density throughout, and 134 (68.0%) never had a reduction in transfusion density. For those patients who showed a reduction, the average value in the monthly rate was -1.63 units per month (SD: 2.12, median: -0.96) compared to first check-up. Figure
6A shows the monthly RBC transfusion density for chelated patients with and without an erythroid response and non-chelated patients. In terms of becoming transfu- sion independent, 35 (17.8%) of the 197 treated patients had at least one interval between check-ups of approxi- mately six months during which they had not received any further transfusions and 19 (9.6%) of the 197 patients were transfusion independent during more than one interval between check-ups after starting chelation thera- py. In total, 54 patients (27.4%) became (temporarily) transfusion independent. In total, 77 chelated patients had an erythroid response: 61 patients had a reduction in transfusion density, and 16 patients who did not have a reduction in transfusion density became transfusion inde- pendent during at least one interval between check-ups.
P<0.001
Figure 4. Adjusted overall survival by iron chela- tion therapy as a time-dependent variable in matched patients.
Figure 5. Changes in transfusion density over time in chelated and non-chelated patients. Time: eight 6-monthly visits.
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