New progress in iron chelation therapy

Iron is required for many enzymes which are critical for cellular functions and plays an important role in oxygen carrying proteins, e.g. hemoglobin. But it can be toxic when present in excess. Therefore, the total body iron store should be kept within defined limits. When there is excess of iron in the body, it is called iron overload. If it is untreated, it will damage the target organs, including the heart, liver and endocrine organs. Clinically we can use phlebotomy or iron chelators to treat iron overload. In the past 3 or 4 decades, only one available iron chelator "deferoxamine" can be used. However, poor compliances and inconvenience are major problems. During the past few years the advances on iron chelation research has been impressive, leading to the development of new oral iron chelators including deferiprone and deferasirox. The new treatment options greatly enhance the efficacy of iron chelation for preventing and treating the iron overload complications. Whichever iron chelator is chosen, patients should be closely monitored both for effectiveness of therapy and for toxic side effects.