{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:34:53Z","timestamp":1787841293073,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,7,10]],"date-time":"2014-07-10T00:00:00Z","timestamp":1404950400000},"content-version":"vor","delay-in-days":1378,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                    <jats:p>Cardiac events and death are not uncommon in adults with \u03b2-thalassemia (\u03b2-TM) taking deferoxamine (DFO) monotherapy because of poor compliance and possibly the less effectiveness of DFO in controlling cardiac iron overload. We sought to assess compliance with DFO, the percentage of shift to other iron chelators, and the occurrence of cardiac siderosis, and cardiac events and death in \u03b2-TM patients on DFO monotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN AND SETTING:<\/jats:title>\n                    <jats:p>Prospective, observational, 10-year follow-up of patients attending Ain Shams Thalassemia Unit, Cairo, Egypt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>For all \u03b2-TM patients aged 2-18 years attending the unit during January 1998 and taking DFO, we recorded all cardiac events (whether fatal or not) during January 2008. All patients still on DFO monotherapy and with a normal EKG and not showing symptoms or signs suggestive of heart failure (HF) were evaluated for cardiac siderosis by T2*.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 412 patients, only 126 (31%) were still taking DFO monotherapy (only 43% of those were compliaant), 136 were taking combined DFO and deferiprone (DFP), 72 were taking DFP and 32 were taking deferasirox (DFX). Twenty-one were lost follow-up and 25 died (10 cardiac). Eight of ten cardiac deaths and 12 of 15 non-carddiac deaths were in the DFO monotherapy group. Those taking DFO monotherapy with no HF and left ventricular ejection fraction (LVEF) by T2* &gt;56% had a median age of 19 years and 56% were males; cardiac T2* was &lt;20 ms in 30 (22%); 10-20 ms in 20 (14.7%) and &lt;10 ms in 10 (7.3%). LVEF ranged from 58%-76 % (median 64%). Forty percent of T2* patients &lt;10 ms were compliant with DFO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Fifty-eight percent of patients on DFO monotherapy were noncompliant, but even compliance did not prevent severe cardiac siderosis and most cardiac events (whether fatal or not) that occurred in the DFO monotherapy group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5144\/1658-3876.2010.174","type":"journal-article","created":{"date-parts":[[2014,7,16]],"date-time":"2014-07-16T11:41:27Z","timestamp":1405510887000},"page":"174-178","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Cardiac events and cardiac T2* in Egyptian children and young adults with \u03b2-thalassemia major taking deferoxamine"],"prefix":"10.4103","volume":"3","author":[{"given":"Mohsen S.","family":"Elalfy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman A.","family":"Abdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usama R.","family":"El Safy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed S.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma S.","family":"Ebeid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doria S.","family":"Salem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"10.5144\/1658-3876.2010.174_bb0005","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1600-0609.2007.01018.x","article-title":"The heart in transfusion dependent homozygous thalassemia today-prediction and management","volume":"80","author":"Aessopos","year":"2008","journal-title":"Eur J Haematol"},{"issue":"10","key":"10.5144\/1658-3876.2010.174_bb0010","first-page":"1187","article-title":"Survival and complications in patients with thal-assemia major treated with transfusion and deferoxamine","volume":"89","author":"Borgna-Pignatti","year":"2004","journal-title":"Haematologica"},{"key":"10.5144\/1658-3876.2010.174_bb0015","unstructured":"El-Alfy MS, Sari TT, Chan LL, Tricta F, El-Beshlawy A. The Safety, Tolerability, and Efficacy of a Liquid Formulation of Deferiprone in Young Children with Transfusional Iron Overload. Pediatric Blood and Cancer in Press"},{"issue":"7","key":"10.5144\/1658-3876.2010.174_bb0020","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00277-008-0471-2","article-title":"Iron chelation in thalassemia: combined or mono-therapy?. The Egyptian experience","volume":"87","author":"El-Beshlawy","year":"2008","journal-title":"Ann Hematol."},{"issue":"6","key":"10.5144\/1658-3876.2010.174_bb0025","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1080\/10245330701521614","article-title":"Pattern of iron chelation therapy in Egyptian beta thalassemic patients: Mansoura University Children\u2019s Hospital experience","volume":"12","author":"Abdelrazik","year":"2007","journal-title":"Hematology"},{"issue":"3","key":"10.5144\/1658-3876.2010.174_bb0030","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1080\/10976640600698155","article-title":"Myocardial iron loading in patients with thalassemia major on deferoxamine chelation","volume":"8","author":"Tanner","year":"2006","journal-title":"J Cardiovasc Magn Reson"},{"key":"10.5144\/1658-3876.2010.174_bb0035","doi-asserted-by":"crossref","first-page":"3738","DOI":"10.1182\/blood-2005-07-2948","article-title":"Randomized controlled trial of deferiprone or deferoximine in beta-thalassaemia major patients with asymptomatic myocardial siderosis","volume":"107","author":"Pennell","year":"2006","journal-title":"Blood."},{"key":"10.5144\/1658-3876.2010.174_bb0040","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1182\/blood-2003-08-2841","article-title":"Value of sequential monitoring of left ventricular ejection fraction in the management of thalassemia major","volume":"104","author":"Davis","year":"2004","journal-title":"Blood."},{"key":"10.5144\/1658-3876.2010.174_bb0045","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1053\/euhj.2001.2822","article-title":"Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload","volume":"22","author":"Anderson","year":"2001","journal-title":"Eur Heart J"},{"issue":"6","key":"10.5144\/1658-3876.2010.174_bb0050","doi-asserted-by":"crossref","first-page":"917","DOI":"10.3324\/haematol.12513","article-title":"Onset of cardiac iron loading in pediatric patients with thalassemia major","volume":"93","author":"Wood","year":"2008","journal-title":"Hematologica"},{"issue":"3","key":"10.5144\/1658-3876.2010.174_bb0055","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1080\/10976640600698155","article-title":"Myocardial iron loading in patients with thalassemia major on deferoxamine chelation","volume":"8","author":"Tanner","year":"2006","journal-title":"J Cardiovasc Magn Reson"},{"issue":"7","key":"10.5144\/1658-3876.2010.174_bb0060","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1038\/sj.thj.6200569","article-title":"Liver iron concentration and fibrosis in a cohort of transfusion-dependent patients on long-term desferrioxamine therapy","volume":"5","author":"Berdoukas","year":"2005","journal-title":"J Hematol"},{"key":"10.5144\/1658-3876.2010.174_bb0065","series-title":"Biostatistics: A foundation for analysis in the health sciences","author":"Daniel","year":"1995"},{"issue":"5","key":"10.5144\/1658-3876.2010.174_bb0070","first-page":"685","article-title":"Lack of correlation between iron overload cardiac dysfunction and needle liver biopsy iron concentration","volume":"90","author":"Berdoukas","year":"2005","journal-title":"Hematologica"},{"issue":"4","key":"10.5144\/1658-3876.2010.174_bb0075","doi-asserted-by":"crossref","first-page":"557","DOI":"10.3324\/haematol.2009.014696","article-title":"EPIC Study Investigators. Tailoring iron chelation by iron intake and serum ferritin: the prospective EPIC study of deferasirox in 1744 patients with transfusion-dependent anemias","volume":"95","author":"Cappellini","year":"2010","journal-title":"Haematologica"},{"key":"10.5144\/1658-3876.2010.174_bb0080","first-page":"952","article-title":"Predictors of abnormal myocar-dial function and T2* in children and young adults with thalassemia major","volume":"102","author":"Wood","year":"2003","journal-title":"Blood."},{"issue":"20","key":"10.5144\/1658-3876.2010.174_bb0085","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1161\/CIRCULATIONAHA.109.874487","article-title":"Cardiac T2* magnetic resonance for prediction of cardiac complications in thalassemia major","volume":"120","author":"Kirk","year":"2009","journal-title":"Circulation"},{"issue":"1","key":"10.5144\/1658-3876.2010.174_bb0090","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1532-429X-10-42","article-title":"Improved survival of thalassaemia major in the UK and relation to T2* cardiovascular magnetic resonance","volume":"10","author":"Modell","year":"2008","journal-title":"J Cardiovasc magn reson"},{"key":"10.5144\/1658-3876.2010.174_bb0095","article-title":"Normalisation of total body iron load with very intensive combined chelation reverses cardiac and endocrine complications of thal-assaemia major","volume":"12","author":"Farmaki","year":"2009","journal-title":"Br J Haemato"},{"key":"10.5144\/1658-3876.2010.174_bb0100","first-page":"12","article-title":"Efficacy of deferasirox in reducing and preventing cardiac iron overload in {beta}-thalassemia","author":"Pennell","year":"2009","journal-title":"Blood"},{"key":"10.5144\/1658-3876.2010.174_bb0105","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1532-429X-10-12","article-title":"Combined chelation therapy in thalassemia major for the treatment of severe myocardial siderosis with left ventricular dysfunction","volume":"10","author":"Tanner","year":"2008","journal-title":"J Cardiovasc Magn Reson."},{"key":"10.5144\/1658-3876.2010.174_bb0110","first-page":"964897","article-title":"Prevention of cardiomyopathy in transfusion-dependent homozygous thalassaemia today and the role of cardiac magnetic resonance imaging","author":"Aessopos","year":"2009","journal-title":"Adv Hematol. 2009"},{"issue":"6","key":"10.5144\/1658-3876.2010.174_bb0115","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1002\/ajh.21711","article-title":"Daily alternating deferasirox and deferiprone therapy for \u201chard-to-chelate\u201d beta-thalassemia major patients","volume":"85","author":"Balocco","year":"2010","journal-title":"Am J Hematol"},{"issue":"4","key":"10.5144\/1658-3876.2010.174_bb0120","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1159\/000313447","article-title":"Improved Treatment Satisfaction and Convenience with Deferasirox in Iron-Overloaded Patients with beta-Thalassemia: Results from the ESCALATOR Trial","volume":"123","author":"Taher","year":"2010","journal-title":"Acta Haematol"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387610500062?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387610500062?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/02275670-201003040-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:51Z","timestamp":1787838531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/02275670-201003040-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,10]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2010]]}},"URL":"https:\/\/doi.org\/10.5144\/1658-3876.2010.174","relation":{},"ISSN":["1658-3876"],"issn-type":[{"value":"1658-3876","type":"print"}],"subject":[],"published":{"date-parts":[[2010,10]]}}}