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Transfusion support is required for patients with severe aplastic anemia, but it can lead to iron overload. Each unit of blood contains 200 mg of iron, and, after multiple transfusions, the body's ability to bind and store iron is overwhelmed. Then, unbound (free) iron induces reactive oxygen species and cell injury. Iron chelation therapy can decrease the iron burden, but the most commonly used agent, deferoxamine, requires parenteral administration and close follow-up monitoring.
To investigate the efficacy and safety of an oral iron chelator — deferasirox— researchers conducted a manufacturer-funded, prospective study involving 116 patients with aplastic anemia. Drug doses, initiated at 20 mg/kg/day, could be increased up to 40 mg/kg/day,…