For some reasons and for some persons it can be useful to combine two chelators. This year conference of the American Society of Hematology in Orlando,Florida, presented several studies concerning Thalassemia and Iron chelation.
http://ash.confex.com/ash/2010/webprogram/start.html4269 Combined Chelation Therapy with Deferasirox and Deferoxamine In Transfusion-Dependent Thalassemia
When you type in the number and title of the abstract into the link above you can read the whole text of the abstract.
The combination of different chelators can enhance the chelation efficiency by reducing different tissue iron stores and control of the toxic labile iron pool. it might be, then, not necessary to take high dosies of a single drug
The study patients were a group of transfusion-dependend thalassemia patients who had no success with standard monotherapy with one chelator.
The duration of the therapy was 52 weeks.
DSX (20-30 mg/Kg) was administered daily and DFO (35-50 mg/Kg/infusion) was infused on 3-7 days/week (as 8-12 hour infusion)."
The results were good: The median LIC declined by 48 %, the median ferritin fell by 43%. There was progressive decline in median plasma NTBI level during the study from 3.26 µM (1.79-5.79 µM) at baseline to 2.38 µM (1.59-3.08 µM) at 12 months (p=0.008)
Also other parameters of patients with different problems improved. Please read the interesting details from the link above.
There were neither significant toxicity or unusual adverse events, and also no elevation of serum creatinine or ALT
Citation: "These results suggest that simultaneous administration DSX and DFO is well tolerated and has low potential for toxicity. Combined chelation therapy appears to be effective in rapidly reducing systemic iron burden, lowering myocardial iron, and controlling plasma NTBI and LPI in patients at risk of developing end-organ damage. "