{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:36:15Z","timestamp":1760189775342,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Deferasirox is an oral chelator approved for iron overload, which has a potential side effect of renal Fanconi syndrome, with proximal tubular dysfunction and tubular acidosis. Monitoring of renal function is recommended, though no standard for monitoring exists. We aim to describe cases of deferasirox\u2010associated Fanconi syndrome in adults and the renal monitoring required to detect these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We present a review of the literature and six cases from our institution of deferasirox\u2010associated partial Fanconi syndrome in adult patients with transfusional iron overload secondary to \u03b2\u2010thalassemia or Diamond Blackfan Anaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While prior cases in the literature occurred at high doses of deferasirox, our series included patients on doses as low as deferasirox 10\u00a0mg\/kg who had been aggressively chelated. All patients had resolution of laboratory abnormalities with drug interruption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rather than chelating to normal iron levels, this series supports prior suggestions that deferasirox dose be reduced if ferritin &lt;500\u20131000\u00a0ng\/ml, and also supports dose reduction if liver iron content &lt;3\u00a0mg iron per g dry weight or for those undergoing aggressive chelation with rapid decrease in iron. Monitoring with metabolic panel and urinalysis were sufficient to detect clinically significant proximal tubular dysfunction, but should be followed up with additional studies to confirm the diagnosis while deferasirox dose is decreased or held.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.13064","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T03:36:16Z","timestamp":1612582576000},"page":"793-797","source":"Crossref","is-referenced-by-count":11,"title":["Deferasirox\u2010associated Fanconi syndrome in adult patients with transfusional iron overload"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-9530","authenticated-orcid":false,"given":"Jennifer C.","family":"Yui","sequence":"first","affiliation":[{"name":"Division of Hematology Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdallah","family":"Geara","sequence":"additional","affiliation":[{"name":"Renal\u2010Electrolyte and Hypertension Division University of Pennsylvania Pennsylvania PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Sayani","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology University of Pennsylvania Pennsylvania PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.3324\/haematol.2009.014696"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1097\/MPH.0b013e3181ec0c4d"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1038\/nrneph.2014.121"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1111\/nep.12523"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1111\/bjh.13002"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1002\/ajh.21588"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1093\/ndt\/gfq224"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1002\/jbmr.522"},{"key":"e_1_2_8_10_1","first-page":"177","article-title":"A case report of deferasirox\u2010induced kidney injury and Fanconi syndrome","volume":"112","author":"Murphy N","year":"2013","journal-title":"WMJ"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1002\/pbc.25995"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1053\/j.ajkd.2009.03.013"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1002\/pbc.22711"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1111\/j.1537-2995.2010.02939.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1097\/MPH.0b013e3181ec0c38"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1080\/20009666.2019.1650592"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1053\/ajkd.2003.50037"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1002\/ajh.21119"},{"unstructured":"LalA:Monitoring Deferasirox Therapy; Monitoring Deferasirox Therapy; Thalassemia Management Checklists. Cooley\u2019s Anemia Foundation.https:\/\/www.thalassemia.org\/boduw\/wp\u2010content\/uploads\/2018\/05\/Monitoring\u2010Deferasirox\u2010Therapy.pdf","key":"e_1_2_8_19_1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_20_1","DOI":"10.1136\/bcr-2020-234542"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.13064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.13064","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.13064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T02:23:44Z","timestamp":1693103024000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.13064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/vox.13064"],"URL":"https:\/\/doi.org\/10.1111\/vox.13064","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"type":"print","value":"0042-9007"},{"type":"electronic","value":"1423-0410"}],"subject":[],"published":{"date-parts":[[2021,2,2]]}}}