Advised to start chelation
My mother has been advised to start chelation therapy. From dx, she has received 20 units, and is doing fine as of now, being able to care for herself, has decent appetite and so on..Her recent ferritin levels are 2600 at one lab and 3600 at another, within the same week.
The chelation drug prescibed is Assunra(made by Novartis), same as Exjade.It is used extensively by Thalassemia patients(mostly children), who are transfusion dependent from birth due to a genetic disorder.
I am extremely worried about if and how she will tolerate this medicine. She is 77 years. I understand the iron overload and associated toxicity, but would be gratfeul if i could get some advice on the following:
1. How long(months/years) does the iron overload take to cause damage?
2. The iron overload may create damage at a later stage, but the chelation drug will start its renal & hepatic damage almost immediately, is it better to not take the chelation drug?
3. If the kidney & liver get affected, will the affects reverse on stopping the drug?
4. Will normal anti-nausea/anti-diarhea medicines help control these symptoms?
5.What are the factors that one should consider before starting on this? Is it advisable to get heart & liver MRI done to see if there is already an overload happening?
Thanks in advance for any suggestions and experience.
Mother age 79, dx MDS RCMD low risk del 20q April 2013, no response to EPO, Danazol. pRBC tx dependent - 2 units every 3-4 weeks, exjade Dec 2013 - Mar2014, restarted Dec 2014