title: When should iron chelation therapy be considered in patients with myelodysplasia and other bone marrow failure syndromes with iron overload?
abstract: Despite the absence of a robust evidence base, there is growing consensus that effective treatment of iron overload leads to decreased morbidity and premature mortality in patients with good prognosis myelodysplastic syndromes (MDSs). Furthermore, new treatment modalities, including disease-modifying therapies (lenalidamide and azacytidine) and reduced intensity conditioning therapies for allogeneic blood stem cell transplants, are offering the prospect of longer survival for patients with traditionally less favourable prognosis MDS, who might also benefit from iron chelation. This article proposes assessment of patients with MDS and related bone marrow failure syndromes to determine suitability for iron chelation. Iron chelation therapy options and monitoring are discussed.
authors.affiliation: Pathology Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. robert_bird@health.qld.gov.au
authors.forename: R J
authors.initials: RJ
authors.lastname: Bird
authors.forename: M
authors.initials: M
authors.lastname: Kenealy
authors.forename: C
authors.initials: C
authors.lastname: Forsyth
authors.forename: J
authors.initials: J
authors.lastname: Wellwood
authors.forename: M F
authors.initials: MF
authors.lastname: Leahy
authors.forename: J F
authors.initials: JF
authors.lastname: Seymour
authors.forename: L B
authors.initials: LB
authors.lastname: To
mesh_terms: D000741:Anemia, Aplastic; D001855:Bone Marrow Diseases; D000080983:Bone Marrow Failure Disorders; D015913:Chelation Therapy / Q000379:methods*; D006457:Hemoglobinuria, Paroxysmal / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007501:Iron / Q000097:blood*; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000097:blood / Q000188:drug therapy*; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007502:Iron Chelating Agents; D007501:Iron