Iron chelators may enhance erythropoiesis by increasing iron delivery to haematopoietic tissue and erythropoietin response in iron-loading anaemia.
Based on the mode of action of iron chelators, one might expect a decrease in bone marrow iron availability, resulting in worsening of the anaemia in certain types of iron-loading anaemia. However, improvement of anaemia or reduction in transfusion requirements during chelation treatment has been reported in various types of iron-loading anaemia. It is suggested that iron chelators act as mediators facilitating iron release from storage sites and its delivery to haematopoietic tissues. In addition, a reduction of iron stores may upregulate erythropoietin response and bring about a decrease of disease activity in inflammatory disorders, resulting in a haemoglobin rise. Large trials with (oral) iron chelators are required to verify these possible effects.
Vreugdenhil
G
G
Department of Internal Medicine, University Hospital, Nijmegen, The Netherlands.
Smeets
M
M
Feelders
R A
RA
van Eijk
H G
HG
D000740:Anemia / Q000188:drug therapy* / Q000378:metabolism; D001853:Bone Marrow / Q000187:drug effects / Q000378:metabolism; D015913:Chelation Therapy; D004341:Drug Evaluation; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000378:metabolism* / Q000627:therapeutic use; D006413:Hematopoietic System / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism*; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use
D007502:Iron Chelating Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron