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Purpose of review: For three decades, deferoxamine has been the only approved iron chelator. This drug has an extremely short-half life and is not orally absorbed; thus, a search has been ongoing for alternative chelators with less onerous delivery. Recently, several oral iron chelators and variations of deferoxamine to prolong the half-life have been developed. These and the methods of monitoring iron overload are the subjects of this review.

Recent findings: New chelators, combinations of chelators and regimens for known chelators and their safety and efficacy are being studied in important preclinical and clinical trials.

Summary: The care and clinical outcomes of patients with thalassemia and other iron-overload disorders may be markedly improved by recent discoveries and novel approaches to chelation therapy.

(C) 2005 Lippincott Williams & Wilkins, Inc.