Current Hematologic Malignancy Reports

, Volume 6, Issue 2, pp 136–144 | Cite as

The Relevance of Iron Overload and the Appropriateness of Iron Chelation Therapy for Patients with Myelodysplastic Syndromes: A Dialogue and Debate

Article

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 

Notes

Disclosure

Conflicts of interest

D. Steensma: Participant in scientific advisory boards for Amgen, Johnson & Johnson, Epizyme, Celgene, and Novartis.

References

Recently published papers of interest have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Hematologic Malignancies, Dana-Farber Cancer InstituteHarvard Medical SchoolBostonUSA

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