Combination Deferasirox and Deferiprone for Severe Iron Overload in Thalassemia

Inclusion Criteria: * Alpha or beta thalassemia * Receiving chronic transfusions (at least 20 transfusions in lifetime) with iron overload requiring treatment with chelation * Serum ferritin \>500 ng/ml * Liver iron concentration equal to or greater than 10 mg/g dw (by R2 MRI) or 7 to 10 mg/g dw (by R2 MRI) and not improving OR cardiac T2\* between 6 and \<20 ms * Women of childbearing age must have a negative pregnancy test * Agree to use approved method of contraception for the duration of the study * Subjects must have a good understanding of the study and be willing to comply with study procedures Exclusion Criteria: * Subjects with past history of unexplained neutropenia (ANC \< 1500/mcL), clinically significant renal disease (creatinine above the upper limit of normal), proteinuria \>300 mg/L, clinically significant liver disease (ALT \> 5x upper limit of normal), pulmonary or cardiovascular disease * History of other clinically relevant oral, endocrine, neurologic, psychiatric, immunologic, bone marrow or skin disorder that contraindicates dosing with deferasirox or deferiprone * History of adverse reaction or known allergy to either deferasirox or deferiprone necessitating drug discontinuation * Currently receiving treatment for active hepatitis * Use of any investigational agent in the past 30 days * Cardiac T2\* \<6 ms, left ventricular ejection fraction \< 56%, and/or arrhythmia (certain subjects may be eligible if they have already had a trial of deferoxamine and deferiprone). Subjects who refuse to use deferoxamine after extensive consultation with at least 2 health care providers will also be allowed to participate. * Pregnant or breastfeeding females * Unwilling or unable to comply with study related procedures