Updates on Management of transfusion induced Iron Overload: A Systematic Review

Hyder Osman Mirghani; Najla Khaldun A Alanazi; Mohammed  Bahjan M ALqarni; Awadh Salh Alshehri; Atheer  Abdullah Alshreef; Tariq  Bander F Alanazi; Ghaida  Bandar J Alanazi; Rammy  Abdullah A Asseiri; Mohammed Khalid Al Makir; Abdulaziz Salim Alhwiati; Talal  Omar S Alzahrani; Yasmeen  Sleem E Alhawiti; Abdulaziz  Abdulkhaliq A Alwakeel; Ahmed  Tariq A Alghabban

doi:10.54293/smhj.v3i3.84

Authors

Hyder Osman Mirghani Associate Prof of Internal medicine, University of Tabuk, Tabuk, KSA. https://orcid.org/0000-0002-5817-6194
Najla Khaldun A Alanazi Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Mohammed Bahjan M ALqarni Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Awadh Salh Alshehri Student, Faculty of Medicine, Tabuk University, Tabuk, KSA. https://orcid.org/0009-0007-9681-3768
Atheer Abdullah Alshreef Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Tariq Bander F Alanazi Medical intern, Faculty of Medicine in Tabuk University, Tabuk, KSA. https://orcid.org/0000-0001-5027-3240
Ghaida Bandar J Alanazi Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Rammy Abdullah A Asseiri Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Mohammed Khalid Al Makir Student, Faculty of Medicine, Tabuk University, Tabuk, KSA. https://orcid.org/0009-0009-5195-3964
Abdulaziz Salim Alhwiati Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Talal Omar S Alzahrani Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Yasmeen Sleem E Alhawiti Student, Faculty of Medicine, Tabuk University, Tabuk, KSA. https://orcid.org/0009-0009-4825-6199
Abdulaziz Abdulkhaliq A Alwakeel Medical intern, Faculty of Medicine, Tabuk University, Tabuk, KSA.
Ahmed Tariq A Alghabban Student, Faculty of Medicine, Tabuk University, Tabuk, KSA.

DOI:

https://doi.org/10.54293/smhj.v3i3.84

Keywords:

Iron overload, Blood transfusion, Chelation, Management, Systematic review

Abstract

Multiple blood transfusions lead to an excess iron buildup in the body's organs, which damages the organs. This systematic review investigated the recently published approaches to manage transfusion-induced iron overload. PubMed, SCOPUS, Web of Science, Science Direct, and Cochrane Library were systematically searched to include the relevant literature. Rayyan QRCI was used throughout this systematic approach. Our results included eleven studies with a total of 1635 patients diagnosed with transfusional iron overload. Iron excess is a major challenge in patients with chronic anemia who require frequent transfusions. Evidence from numerous clinical trials has shown that giving chelation therapy to individuals with transfusion-induced iron overload clearly reduced their iron burden and improved organ function. We found that Amlodipine, lupatercept, and chelating agents are safe and effective options for transfusion dependant thalassemia (TDT) patients. Additionally, Amlodipine or lupatercept combined with chelating agents are more efficient in lowering serum ferritin and o regularly drank green tea experienced significant reductions in iron accumulation. Deferiprone (DFP) has provided sickle cell disease (SCD) patients with a new therapeutic choice. The effects of this oral iron chelator were equivalent to those of deferoxamine (DFX) given subcutaneously in terms of reducing transfusional iron excess. In line with what had previously been seen in thalassemia syndrome patients, DFP showed a tolerable safety profile.