Drug Interactions between deferoxamine and lovotibeglogene autotemcel

ADJUST DOSING INTERVAL: Myelosuppressive iron chelators (e.g., deferiprone) and non-myelosuppressive iron chelators (e.g., deferasirox, deferoxamine) may decrease the effectiveness of the autologous hematopoietic stem cell-based gene therapy, lovotibeglogene autotemcel. The exact mechanism has not been fully described but may involve the potential for the antiproliferative properties of iron chelators to interfere with the hematopoietic stem cell (HSC) mobilization regimen needed to obtain CD34+ cells for lovotibeglogene autotemcel manufacturing, as well as the potential for interference with the myeloablative conditioning regimen administered prior to the lovotibeglogene autotemcel infusion. Myelosuppressive iron chelators (e.g., deferiprone) may also increase the risk and/or severity of bone marrow suppression if given too soon after the lovotibeglogene autotemcel infusion. No data are currently available for this interaction.

MANAGEMENT: The manufacturer of lovotibeglogene autotemcel recommends discontinuing the use of myelosuppressive and non-myelosuppressive iron chelators at least 7 days prior to the initiation of HSC mobilization, and at least 7 days prior to the initiation of myeloablative conditioning. After lovotibeglogene autotemcel administration, use of myelosuppressive and non-myelosuppressive iron chelators should be avoided for at least 6 months and 3 months, respectively. Phlebotomy may be used in lieu of iron chelation, when appropriate. Consultation with product labeling and local or institutional guidelines may be appropriate for further recommendations.