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Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders.

Abstract

New measures of iron accumulation in liver and heart (superconducting quantum inference device and magnetic resonance imaging), and oral iron chelators (deferiprone and deferasirox) are available for managing iron overload in thalassemia major. To assure appropriate use of these new health technologies, the Italian Society of Hematology appointed a panel of experts to produce clinical practice-guidelines for the management of iron overload in thalassemia major and related disorders. The analytical hierarchy process, a technique for multicriteria decision analysis, was applied to relevant key questions in order to identify the alternative strategies, generate explicit criteria for their evaluation, and check how well the alternatives fulfilled the criteria. The result of a comprehensive systematic review of articles released from 1990 to 2007 was used as a source of scientific evidence to compare the decisional options pairwise, and select the final recommendation. Every step in the model was developed from questionnaires and group discussion. The resulting recommendations advise about which examination to carry out in order to plan iron chelation therapy, when to start iron chelation, which iron chelator to choose in regularly transfused patients, how to monitor iron chelation therapy, and when and how to switch standard therapy.

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  • Authors

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    Source

    Haematologica 93:5 2008 May pg 741-52

    MeSH

    Adolescent
    Adult
    Benzoates
    Child
    Decision Support Techniques
    Deferoxamine
    Hematology
    Humans
    Iron Chelating Agents
    Iron Overload
    Liver
    Practice Guidelines as Topic
    Pyridones
    Siderophores
    Triazoles
    beta-Thalassemia

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18413891

    Citation

    TY - JOUR T1 - Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders. AU - Angelucci,Emanuele, AU - Barosi,Giovanni, AU - Camaschella,Clara, AU - Cappellini,Maria Domenica, AU - Cazzola,Mario, AU - Galanello,Renzo, AU - Marchetti,Monia, AU - Piga,Antonio, AU - Tura,Sante, Y1 - 2008/04/15/ PY - 2008/4/15/aheadofprint PY - 2008/4/17/pubmed PY - 2008/9/25/medline PY - 2008/4/17/entrez SP - 741 EP - 52 JF - Haematologica JO - Haematologica VL - 93 IS - 5 N2 - New measures of iron accumulation in liver and heart (superconducting quantum inference device and magnetic resonance imaging), and oral iron chelators (deferiprone and deferasirox) are available for managing iron overload in thalassemia major. To assure appropriate use of these new health technologies, the Italian Society of Hematology appointed a panel of experts to produce clinical practice-guidelines for the management of iron overload in thalassemia major and related disorders. The analytical hierarchy process, a technique for multicriteria decision analysis, was applied to relevant key questions in order to identify the alternative strategies, generate explicit criteria for their evaluation, and check how well the alternatives fulfilled the criteria. The result of a comprehensive systematic review of articles released from 1990 to 2007 was used as a source of scientific evidence to compare the decisional options pairwise, and select the final recommendation. Every step in the model was developed from questionnaires and group discussion. The resulting recommendations advise about which examination to carry out in order to plan iron chelation therapy, when to start iron chelation, which iron chelator to choose in regularly transfused patients, how to monitor iron chelation therapy, and when and how to switch standard therapy. SN - 1592-8721 UR - https://www.unboundmedicine.com/medline/citation/18413891/full_citation L2 - http://www.haematologica.org/cgi/pmidlookup?view=long&pmid=18413891 ER -