Welcome Message by Annita Kolnagou MD,
President of the Local Organising Committee

Welcome to Paphos, Cyprus, host of the 21st ICOC and birthplace of the ancient goddess of love Aphrodite, who according to ancient Greek mythology was born from the foam of the sea waves. The venue of the conference, Laura Beach Hotel, is situated in a quiet green belt area by the sea front with direct views of the blue Mediterranean sea and nearby sandy beaches. The tranquillity of the venue and the excellent Cypriot cuisine will be an important ?aphrodisiac? for a very stimulating ICOC conference.

One in six Cypriots is a carrier of thalassaemia and one in a thousand Cypriots is a thalassaemia patient. Preventative measures including prenatal and antenatal diagnosis and educational efforts have almost completely obliterated the birth of thalassaemia children in Cyprus. Most importantly, new developments in the area of chelation therapy and other supporting therapies have resulted in substantial improvement in the quality of life and a sharp decrease in mortality. In my clinic in the thalassaemia unit of Paphos General Hospital, most patients are active professionals, have families and in one case a female thalassaemia patient had four children. An increasing number of thalassaemia patients are now becoming grandparents.

A new era has begun in the field of iron chelation therapy. Following the introduction of the deferiprone / deferoxamine ICOC combination protocol several years ago, almost a third of the thalassaemia patients in my clinic have reached normal range body iron store levels (NRBISL) and more patients are joining this category. This new era brings important new research challenges and findings since the treatment of thalassaemia patients with NRBISL have a different ferrikinetic profile and require different chelation treatment in comparison to more heavily iron loaded patients. The above developments and new epidemiological findings suggest that at least in Cyprus, thalassaemia is changing from a fatal to a chronic disease.

In addition to thalassaemia, recent epidemiological studies suggest that another very serious inherited disease related to iron metabolism, namely Friedreich Ataxia, is also very common in the Paphos district. A similar policy to that of thalassaemia has been adopted by the government to control the birth of patients with Friedreich Ataxia by screening for carriers among premarital couples and providing prenatal diagnosis.

The scientific programme will be complemented with many social activities and entertainment every night. Those coming to Paphos for the first time will have the opportunity to visit the archaeological sites by the Paphos Harbour and also the Baths of Aphrodite at Latsi. We hope that as with previous ICOC conferences all participants will have memorable experience and an enjoyable and relaxing time.

Annita Kolnagou MD

Welcome Message by Des R. Richardson, President of ISOCAM society

As President of the International Society of Chelators and Metals (ISOCAM), I would like to very much welcome all delegates to the sunny island of Cyprus to join our 21st International Conference on Chelation (ICOC).

This year the conference has attracted a variety of speakers from far and wide on many topics that include not only iron chelation but also other essential metals, actinide, heavy and non-essential metals. All aspects of chelation therapy are included which encompasses the treatment of haemoglobinopathies, cancer, infectious, neurodegenerative and many other diseases.

As in previous years, we strongly encourage all delegates to also bring their trainees, who are also very welcome to present their work.

Finally, all colleagues are asked to become members of the International Society of Chelators and Metals (ISOCAM). There is no financial obligation required and your membership aids in developing the society, as we encourage submissions of ideas for future conferences.

I very much wish all participants enjoy the programme as well as the sights that make up the fabulous locale at the beach-side hotel in Paphos on the beautiful Mediterranean sea.

Des R. Richardson

Welcome Message by George J. Kontoghiorghes, President of ICOC committee

It is with great pleasure that I welcome you to the 21st ICOC in Paphos, Cyprus, on behalf of the ICOC committee and other collaborating and participating organisations.

We are now approaching the 21st birthday of the ICOC conferences. From their onset in 1989, twenty successive ICOC Conferences have chronicled the progression of this increasingly important multidisciplinary medical and scientific area.

Distinguished colleagues from all over the world are gathering to discuss recent advances in the treatment of thalassaemia, cancer, neurodegenerative, cardiac, renal, liver, inflammatory, nutritional, infectious and other diseases. Of equal importance is the discussion on basic sciences and mechanisms associated with these diseases, including chemical, biochemical, pharmacological and toxicological findings with particular emphasis on metals, free radicals and chelators.

We are currently witnessing major breakthroughs in the areas of chelation, identification of genetic and environmental factors affecting metal metabolic pathways and the important role of free radicals in health and disease. The nuclear disaster in Fukisima reminded us for the need to design new chelators for reducing actinide toxicity in humans and environmental pollution. Increasing numbers of other specialisations and disciplines are considering chelation as a possible therapeutic tool in their research protocols, especially for conditions with no satisfactory treatments.

Thousands of iron loaded patients are now treated with the oral chelating drugs deferiprone and deferasirox in addition to deferoxamine. For the first time the complete and effective removal of excess iron and the normalization of the iron stores in transfused patients has been achieved using the ICOC protocols. The introduction of effective chelation protocols for treating non iron loading conditions such as cancer, neurodegenerative and infectious diseases is also in progress with encouraging results. Chelating drugs in these conditions could be used as main, alternative or complimentary therapy. Future research challenges include the role of chelators in new disciplines such as metallogenomics, pharmacogenomics and nutrigenomics.

Despite the major breakthroughs in chelation therapies, serious controversies still remain such as the lack of supply of chelating drugs to thousands of patients in developing countries. Similarly, the lack of transparency during drug development has led to misleading information that may have harmed many patients. It is hoped that by continuous global collaboration on education and research and by organisation of conferences such as ICOC, progress can be achieved in many of these areas.

I am confident that as in previous ICOC meetings, we will organise a pleasant stay and a constructive, high standard scientific meeting in Paphos. I would like to take the opportunity to thank all the members of the organising and scientific committees, the participants and sponsors and all others who have contributed to the organisation of the 21st ICOC conference.

George J Kontoghiorghes