Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_35_библиотеки_им_акад_М_И_Перельмана

Iron chelation in children, like adults, tends to rst con­sider DFO therapy, mainlydue to a better side effect prole and compliance compared to DFX. Children should be monitored for adverse effects on bone growth, particularly defects like rickets-like bone lesions, metaphyseal changes, and spinal damage with loss of sitting height. Auditory adverse events should also be done, particularly in children with a low iron burden, as they tend to be more prone to adverse auditory effects from chelation therapy. DFX can be used as second-line therapy as it is FDA approved as rst-line therapy for chronic iron overload due to blood transfusions. DFX, in comparison to DFO, has seen less reported adverse events on growth or development in patients with SCD or thalassemia. Renal function, however, should be monitored closely, as it has been associated with decreases in GFR in case series [41]. DFP is approved as second-line therapy for transfusional iron overload due to thalassemia syndromes by the FDA.However, it should be avoided in children with a history of unexplained neutrope­nia or bone marrow failure syndromes [6]. Adverse bone growth effects, such as bony dysplasia and deformation have also been reported [42]. (Lastly, children with neo­plastic blood disorders and those having received bone marrow transplant should be treated for iron overload via periodic phlebotomy or iron chelation in the setting of severe iron overload [6].