Novel treatment options for transfusional iron overload in patients with myelodysplastic syndromes.
Red blood cell transfusion dependency is common in myelodysplastic syndromes and is associated with inferior survival. The use of parenteral deferoxamine therapy for transfusional iron overload has been sparse, in part due to cumbersome administration schedules. Deferasirox is an oral iron-chelating agent with favorable pharmacokinetics, including a long half-life allowing continuous 24-hour chelation with once-daily dosing. Deferasirox produces dose-dependent reductions in liver iron content and reduces cardiac iron levels. In-vitro studies with deferasirox suggest improved cardiomyocyte contractility potentially important in reducing excess cardiac mortality noted in transfusion-dependent MDS. Deferasirox has a manageable safety profile with favorable patient satisfaction reports.
The Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA. sgoldberg@humed.com
Stuart L
SL
Goldberg
D001565:Benzoates / Q000627:therapeutic use*; D000077588:Deferasirox; D000077543:Deferiprone; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy* / Q000209:etiology; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate; D065227:Transfusion Reaction; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
D001565:Benzoates; D007502:Iron Chelating Agents; D011728:Pyridones; D014230:Triazoles; D000077543:Deferiprone; D000077588:Deferasirox