The Relevance of Iron Overload and the Appropriateness of Iron Chelation Therapy for Patients with Myelodysplastic Syndromes: A Dialogue and Debate Authors
First Online: 05 March 2011 DOI:
Cite this article as: Steensma, D.P. Curr Hematol Malig Rep (2011) 6: 136. doi:10.1007/s11899-011-0084-z Abstract
Accumulation of excessive amounts of iron in vulnerable organs and tissues, together with elevated plasma and intracellular concentrations of reactive iron molecules, are likely to be harmful to some patients with myelodysplastic syndromes (MDS) who have received numerous red blood cell transfusions. But what is the real magnitude of risks related to iron overload in MDS, and how strong is the evidence that reducing total body iron and labile plasma iron through treatment with chelating drugs is beneficial to patients? Available data can be interpreted in different ways, and as a result, these topics continue to be areas of heated debate among physicians who care for patients with MDS. Using the traditional but rarely employed format of a classical dialogue, I explore here the potential dangers of iron overload and the risks and benefits of iron chelation therapy for patients with MDS.
Keywords Myelodysplastic syndromes (MDS) Iron overload Transfusional hemosiderosis Deferasirox Deferoxamine Iron chelation therapy Clinical controversy Classical dialogue Labile plasma iron Ferritin Practice guidelines T2* magnetic resonance imaging References Recently published papers of interest have been highlighted as: • Of importance •• Of major importance
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