Hi Chris,
A ferritin value less than 1000 is not supposed to give iron overload symptoms. Actually the latest research shows that it can decrease the bone marrow function but not give symptoms from liver, heart, pancreas and so on
http://abstracts.hematologylibrary.o...urcetype=HWCIT
If the ferritin value is too low (1000 for Desferal and 500 for Exjade) iron chelators can have a negative impact on the eyes and hearing.
You are right about Desferal being safer for kidneys than Exjade but many patients don't have any kidney symptoms when they take Exjade
http://www.rxlist.com/exjade-drug.htm. As you can see 11 % of the thalassemia patients got increased creatinin showing a negative impact on the kidneys.
Many patients start with EPO before transfusions. If your own serumEPO is more than 500 (mine was more than 800) only very few patients have a positive effect when they take EPO. Sometimes you get a better effect with EPO if it is taken with Neupogen or similar drugs
http://www.anemia.org/professionals/...onid=14&topic=
I think that the ferritin level should be controlled before transfusion but not if you take EPO – it is the iron in the transfused red blood cells that leads to iron overload.
Kind regards
Birgitta-A
70 yo, dx MDS Interm-1 May 2006, transfusion dependent from dx, Desferal and Ferriprox (not approved in the US) for iron overload, Neupogen 2 injections/week for low white blood cells, asymptomatic