Title:Pathophysiological and Clinical Aspects of Iron Chelation Therapy in MDS
VOLUME: 18 ISSUE: 22
Author(s):Norbert Gattermann
Affiliation:Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Mooren Str. 5, D-40225 Dusseldorf, Germany.
Keywords:Iron overload, myelodysplastic syndromes, oxidative stress, non-transferrin-bound iron, labile plasma iron, iron chelation, dietary iron, transfusional iron overload, erythropoiesis, hemoglobin
Abstract:The majority of patients with myelodysplastic syndromes (MDS) become transfusion-dependent during the course of disease
and may thus develop transfusional iron overload. As a further contributor to iron overload there is increased absorption of dietary iron
from the gut, as a consequence of ineffective erythropoiesis. Compared with thalassemia, it is less clear how frequent patients with MDS
develop clinical complications of iron overload, and whether the accumulation of iron shortens their survival. This review aims to summarize
our current knowledge of the detrimental effects of transfusional iron overload in MDS, point out the risks associated with ironinduced
oxidative stress, describe the tools available for diagnosing iron overload, indicate the treatment options with currently available
iron chelators, and discuss the measurement of labile plasma iron (LPI) as a tool to monitor the efficacy of iron chelation therapy.
