Caterina Borgna-Pignatti MD	Survival in Thalassaemia - Does the choice of iron chelator make a difference? Learning Objectives Review the most recent survival data for patients with thalassaemia major Gain insight into the improvements seen in patient survival through iron chelation Learn how different iron chelators impact patient survival Review country specific examples on the changes in survival Please Login to access the archives
	The life expectancy of patients with thalassaemia major has significantly increased in recent years. However, iron overload of the heart remains the main cause of morbidity and mortality, being responsible for more than half of all deaths. A recent study from the UK found that 50 percent of patients died before the age of 35. A long-term Italian study found that 65 percent of patients were still alive at that age. To evaluate whether the choice of chelators has an impact on cardiac morbidity and mortality, we compared the occurrence of cardiac disease in patients with thalassaemia major treated only with deferoxamine and in those whose therapy was switched to deferiprone, from January 31, 1995 to December 31, 2003. At baseline, the two groups were comparable for age and sex, while ferritin levels were significantly higher in patients switched to deferiprone. Fifty-two cardiac events, including 10 cardiac deaths, occurred during therapy with deferoxamine. No cardiac events occurred during deferiprone therapy or within 20 months (or more) after therapy ceased. Thus, deferiprone appeared to be more cardioprotective than deferoxamine.