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The protective role of deferoxamine in the prevention of doxorubicin-induced hepatic fibrosis in children: A randomized controlled clinical trial
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| Mohammadreza Bordbar, Gholamreza Fathpour *, Seyed Mohsen Dehghani, Sezaneh Haghpanah, Hossein Molavi Vardanjani, Mohammadreza Fattahi, Mahdi Shahriari, Nader Shakibazad |
| Hematology Research center, Shiraz University of Medical Sciences, Shiraz, Iran |
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Abstract: (429 Views) |
Background: This study aimed to investigate the protective role of deferoxamine (DFO) in the prevention of doxorubicin (DOX)-induced hepatic fibrosis in children.
Methods: In this prospective randomized controlled trial, 61 treatment-naïve children (2-18 years) with different types of cancer who referred to a tertiary teaching hospital in the South of Iran were enrolled. They were randomly assigned to 3 groups; group 1 (control, n=21), group 2 (DFO 10 times DOX dose, n=20), group 3 (DFO 50mg/kg, n=20). DFO was administered as an 8-hour continuous intravenous infusion during and after DOX infusion in each chemotherapy cycle. Non-invasive serum markers of liver fibrosis, including AST-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4) score and Fibro Test were measured in each individual. Besides, hepatic Fibro Scan was used after the last course of chemotherapy to estimate the fibrosis degree.
Results: Alanine aminotransferase was mildly increased after treatment compared to before treatment. The treatment with DFO 10 times DOX dose was associated with a significant decline in post-treatment APRI (adjusted odds ratio 0.17; 95% confidence interval 0.03- 0.84. P-value=0.015). The METAVIR fibro scores were in the F0-F1 zone in all participants, and the results were comparable in study groups. No adverse drug effects were reported in the treatment groups.
Conclusion: DOX may not lead to severe liver fibrosis if the maximum cumulative dose allowed is not exceeded. DFO at the dose of 10 times of DOX dose may have a potential protective role against liver fibrosis. More studies with longer follow-up are needed to further assess this issue. |
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| Keywords: Deferoxamine, Doxorubicin, Hepatic fibrosis, Children |
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Full-Text [PDF 491 kb]
(173 Downloads)
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: Research |
Subject:
Pediatric Hematology & Oncology
Received: 2021/10/12 | Accepted: 2022/07/17 | Published: 2022/09/19
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| * Corresponding Author Address: Hematology Research center, Shiraz University of Medical Sciences, Shiraz, Iran |
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