An international survey of patients with thalassemia major and their views about sustaining life-long desferrioxamine use

BACKGROUND: Management of thalassemia major requires patients to have life-long access to a treatment regimen of regular blood transfusions coupled with iron chelation therapy. The objective of this study was to investigate patients' reasons for missing iron chelation therapy with desferrioxamine, and the support to sustain life-long adherence to treatment. METHODS: From October 1999 to May 2000 a survey of patients with thalassemia major was conducted in ten countries: Cyprus, Egypt, Greece, Hong Kong, India, Iran, Italy, Jordan, Taiwan, and the United States. RESULTS: 1,888 questionnaires (65%) were returned. Most patients (1,573) used desferrioxamine, and 79% administered a dose at least 4 days a week. Inaccessibility of the drug was a common reason for missing a dose in India (51%), and in Iran (25%), whereas, in any other country, it was a reason for less than 17% of patients. Overall, 58% reported reasons for missing a dose related to their beliefs or feelings about the medication, and 42% drug-related side effects. CONCLUSION: Many patients miss doses of desferrioxamine and an opportunity remains to develop interventions that provide more support to sustain use of desferrioxamine

Zirconolite, zircon and monazite-(Ce) U-Th-Pb age constraints on the emplacement, deformation and alteration history of the Cummins Range Carbonatite Complex, Halls Creek Orogen, Kimberley region, Western Australia

In situ SHRIMP U-Pb dating of zirconolite in clinopyroxenite from the Cummins Range Carbonatite Complex, situated in the southern Halls Creek Orogen, Kimberley region, Western Australia, has provided a reliable 207Pb/206Pb age of emplacement of 1009 ± 16 Ma. Variably metamict and recrystallised zircons from co-magmatic carbonatites, including a megacryst ~1.5 cm long, gave a range of ages from ~1043–998 Ma, reflecting partial isotopic resetting during post-emplacement deformation and alteration. Monazite-(Ce) in a strongly foliated dolomite carbonatite produced U-Th-Pb dates ranging from ~900–590 Ma. Although the monazite-(Ce) data cannot give any definitive ages, they clearly reflect a long history of hydrothermal alteration/recrystallisation, over at least 300 million years. This is consistent with the apparent resetting of the Rb-Sr and K-Ar isotopic systems by a post-emplacement thermal event at ~900 Ma during the intracratonic Yampi Orogeny. The emplacement of the Cummins Range Carbonatite Complex probably resulted from the reactivation of a deep crustal structure within the Halls Creek Orogen during the amalgamation of Proterozoic Australia with Rodinia over the period ~1000–950 Ma. This may have allowed an alkaline carbonated silicate magma that was parental to the Cummins Range carbonatites, and generated by redox and/or decompression partial melting of the asthenospheric mantle, to ascend from the base of the continental lithosphere along the lithospheric discontinuity constituted by the southern edge of the Halls Creek Orogen. There is no evidence of a link between the emplacement of the Cummins Range Carbonatite Complex and mafic large igneous province magmatism indicative of mantle plume activity. Rather, patterns of Proterozoic alkaline magmatism in the Kimberley Craton may have been controlled by changing plate motions during the Nuna–Rodinia supercontinent cycles (~1200–800 Ma)