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Iron-Chelating Agents in Non-Iron Overload Conditions

E. E. Voest, MD, PhD; G. Vreugdenhil, MD, PhD; and J. J. M. Marx, MD, PhD
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From the University Hospital Utrecht, Utrecht, and the University Hospital Nijmegen, Nijmegen, the Netherlands. Requests for Reprints: J. J. M. Marx, MD, PhD, Department of Internal Medicine, Utrecht University Hospital, P.O. Box 85500, 3508 GA Utrecht, the Netherlands.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;120(6):490-499. doi:10.7326/0003-4819-120-6-199403150-00008
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Purpose: To review the current clinical experience with iron chelators in non-iron overload conditions.

Data Sources: The English-language literature was searched from 1983 through 1992 manually and using MEDLINE.

Study Selection: Original articles, case reports, and abstracts addressing iron chelation.

Data Extraction: Selected reports that described clinical applications of iron chelators in non-iron overload conditions were classified according to their stated mechanism of interference with disease activity. Articles stating the rationale for clinical use of iron chelators were also included.

Results: Iron chelators were used in non-iron overload conditions to produce antioxidant effects, antiproliferative effects, and antiprotozoal effects and for aluminum chelation. In addition, several reports described singular observations in various diseases. Deferoxamine is the only iron chelator available for clinical studies. The treatment-related (side) effects appear to be associated with patient iron levels.

Conclusions: Randomized clinical trials are needed to confirm the promising effects of iron chelators in non-iron overload conditions. Oral iron chelators with fewer toxic effects are especially needed.




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