Iron chelation therapy for myelodysplastic syndrome: a systematic review and meta-analysis

  • Hailing Liu
  • Nan Yang
  • Shan Meng
  • Yang Zhang
  • Hui Zhang
  • Wanggang ZhangEmail author
Review Article


Iron overload remains a concern in myelodysplastic syndrome (MDS) patients especially those requiring recurrent blood transfusions. Whether iron chelating therapy (ICT) is beneficial to the long-term survival of myelodysplastic syndrome is still a controversial issue. Therefore, we conducted a systematic review and meta-analysis to clarify the relationship between ICT and long-term survival in patients with MDS. A total of 14 studies involving 7242 participants were identified; the outcomes revealed that for patients with MDS, ICT resulted in a lower risk of mortality compared to those with no ICT (HR 0.57; 95% CI 0.44–0.70; P < 0.001); what is more, ICT led to a lower risk of leukemia transformation (HR 0.70; 95% CI 0.52–0.93; P = 0.016). Results of subgroup analyses based on adequate ICT or any ICT, low/int-1 IPSS or unclassified IPSS and study types indicated that the ICT had a beneficial role in all these groups of patients.


Iron overload Iron chelation therapy Myelodysplastic syndrome Overall survival Leukemia-free survival 



This manuscript was supported by Shaanxi International Scientific Research Cooperation and Exchange Program (Grant Number: 2016KW-020).

Compliance with ethical standards

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

The study was approved by the Second Affiliated Hospital of Xi’an Jiaotong University.

Informed consent

Informed consent was obtained from all individual participants included in this study in their original studies.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical HematologySecond Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina

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