An Open Label, Safety and Tolerability Study of Deferasirox for Treatment of Transfusional Iron Overload in Low-Risk and INT-1 Myelodysplastic Patients
Inclusion Criteria:
- Male or female patients with low or intermediate (INT-1) risk MDS, determined via
IPSS criteria, with transfusional iron overload. NOTE: Bone marrow morphology and
cytogenetic studies completed within 3 months prior to screening can be used if the
patient has been hematologically stable. Every attempt to obtain cytogenetics studies
should be made; however, if there is culture failure, repeat marrow aspiration will
not be mandated. In this case, RAEB with less than 11% marrow blasts will be
accepted.
- Patients can be EITHER naïve to iron chelation OR have had prior treatment with
deferoxamine (DFO). DFO must be discontinued the day prior to starting deferasirox
dosing.
- Age: greater than or equal to 18 years
- Serum ferritin:
- For entry into the screening period: serum ferritin greater than or equal to
1000 µg/mL on at least two occasions, at least two weeks apart, during the prior
year. Samples must be obtained in the absence of concomitant infection;
- For enrollment into the study: serum ferritin greater than or equal to 1000
µg/mL at screening (via the central lab) obtained in the absence of concomitant
infection
- A lifetime minimum of 30 previous packed red cell transfusions
- Life expectancy greater than or equal to 6 months
- Women must have a negative serum or urine pregnancy test and use an effective method
of contraception, or must have undergone clinically documented total hysterectomy
and/or oophorectomy, or tubal ligation or be postmenopausal (defined by amenorrhea
for at least 12 months).
- Able to provide written informed consent
Exclusion Criteria:
- Serum creatinine above the upper limit of normal
- ALT greater than 250 U/L during screening
- Clinical or laboratory evidence of active hepatitis B or hepatitis C (HBsAg in the
absence of HBsAb -OR- HCV Ab positive with HCV RNA positive and ALT above the normal
range)
- Significant proteinuria as indicated by a urinary protein/creatinine ratio greater
than 0.5 mg/mg in a non-first void urine sample during screening (or alternatively in
two of three samples obtained for screening)
- History of HIV positive test result (ELISA or Western blot)
- ECOG performance status greater than 2
- Uncontrolled systemic hypertension
- Unstable cardiac disease not controlled by standard medical therapy
- Third degree atrioventricular (AV) block or QT interval prolongation above the normal
range
- History of clinically relevant ocular toxicity related to iron chelation
- Systemic diseases (cardiovascular, renal, hepatic, etc.) which would prevent study
treatment
- Pregnancy or breast feeding
- Treatment with a systemic investigational drug within the past 4 weeks or a topical
investigational drug within the past 7 days.
- Other surgical or medical condition which might significantly alter the absorption,
distribution, metabolism or excretion of any drug. The investigator should be guided
by evidence of any of the following:
- inflammatory bowel syndrome, gastritis, ulcers, gastrointestinal or rectal
bleeding;
- major gastrointestinal tract surgery, such as gastrectomy, gastroenterostomy, or
bowel resection;
- pancreatic injury or pancreatitis or indications of impaired pancreatic
function/injury, as indicated by abnormal lipase or amylase;
- urinary obstruction or difficulty in voiding.
- History of non-compliance to medical regimens or patients who are considered
potentially unreliable and/or not cooperative