Acute Changes in Renal Function Associated With Deferoxamine Therapy

Sir.—Deferoxamine administration is still necessary in the management of thalassemia and, when used appropriately, it is beneficial in controlling iron overload.¹

In the past, the general assumption that deferoxamine treatment was devoid of side effects resulted in a tendency to administer high doses; the reduction of serum ferritin to below 1000 μg/L was considered an objective to pursue with determination.² However, in a review of the recent data reported in the literature,^3-6 Lo Faro et al¹ suggested that the side effects (infections, cataracts, visual-field defects, severe vision loss or more subtle signs of visual and auditory neurotoxicity, and slow growth) of this drug are dose dependent. Moreover, Schilirò and Russo⁷ asserted that normalization of serum ferritin levels in patients with thalassemia should not be the goal of the treatment and that serum ferritin levels three or four times nor