Therapeutic value of combined therapy with Deferiprone and Silymarin as iron chelators in Egyptian Children with Beta Thalassemia major

Background: Beta Thalassemia is inherited anemia characterized by absent or reduced synthesis of β-globin chains of hemoglobin, caused by β-globin gene mutations resulting in chronic hemolytic anemia that requires ‘repeated blood transfusion with resulting iron overload’. Silymarin has iron chelating activity in thalassemic patients with iron overload. Aim of the work: was to study the therapeutic value of combined therapy of Deferiprone and silymarin as iron chelators in Egyptian children with beta thalassemia with iron overload’. Patients and Methods: ‘This study was conducted on 80 beta thalassemic children with their serum ferritin more than 1000 ng/ml who were divided into two groups’. Group I included 40 patients who were treated with oral Deferiprone and silymarin for 9 months. Group II included 40 patients who were treated with oral Deferiprone and placebo for 9 months. Results: ‘There were no significant differences in serum ferritin, iron and TIBC between group I and group II before the study but after regular chelation therapy, serum ferritin and iron were significantly lower in group I than group II. No statistically significant differences in serum creatinine, blood urea, ALT, AST and bilirubin levels between Group I and Group II before and after chelation therapy were observed’. Conclusion: Deferiprone in combination with silymarin are better iron chelators than Deferiprone and placebo. Recommendations: ‘Extensive multicenter studies in large number of patients with longer follow up period and more advanced methods of assessment of iron status to clarify the exact role of silymarin in reduction of iron over load in thalassemic children’.