Iron overload can be a major complication in children requiring chronic red cell transfusions. Compliance with subcutaneous deferoxamine is often poor. We report the use of very high-dose deferoxamine in 14 children. Patients received intravenous deferoxamine at 15 mg/kg/h over 48 hours every 2 or 4 weeks. The mean duration of treatment was 18 months. Therapy was well tolerated and our regimen was successful in removing excess iron. Intermittent very high-dose intravenous deferoxamine is practical, safe, and effective in managing iron overload in children. Treatment can be given as an outpatient without a central venous catheter.
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