title: Clinical characteristics and management of iron overload in 631 patients with chronic transfusion dependency: results from a multicentre, observational study.
abstract: BACKGROUND
  Long-term red blood cell transfusion therapy results in iron overload. Consensus documents have been developed for several transfusion-dependent groups of patients to provide clinicians with guidance on the monitoring and treatment of this transfusion complication. The objective of this study was to describe the clinical characteristics and current standard of care for patients with transfusion dependency in Spain.
  
  
  METHODS
  This observational, multicentre study was conducted from November 2008 to December 2009 in 41 Spanish hospitals and day-care centres. Patients who received their first transfusion after January 2007, and who had received at least 10 units of packed red blood cells at the time of inclusion were eligible for the study.
  
  
  RESULTS
  We collected data from 631 patients with a mean age of 65±17 years. Haematological disease (84% of patients) was the most frequent underlying disorder. Patients had received a mean of 30±26 red blood cell units from diagnosis until inclusion in the study, and a mean of 18±18 red blood cell units in the previous year. Ferritin levels were available before and after starting the study for 116 (18%) and 412 (65%) patients, respectively. Mean ferritin level at study inclusion was 1,570 ng/mL, and 58% of patients had a ferritin level of at least 1,000 ng/mL. In spite of this, only 89 (14%) patients were receiving chelation therapy.
  
  
  CONCLUSIONS
  The management of patients with transfusion dependency could be improved by using ferritin levels to diagnose iron overload and guide the timely start of chelation therapy.
authors.affiliation: Department of Haemotherapy and Haemostasis, Hospital Clínic, IDIBAPS, Barcelona.
authors.forename: Joan
authors.initials: J
authors.lastname: Cid
authors.affiliation: Department of Haematology, Clinical Hospital Lozano Blesa, Zaragoza.
authors.forename: Luis
authors.initials: L
authors.lastname: Palomera
authors.affiliation: Department of Haematology, Son Dureta University Hospital, Mallorca.
authors.forename: Matías
authors.initials: M
authors.lastname: Díaz
authors.affiliation: Department of Haematology, Ramón y Cajal University Hospital, Madrid.
authors.forename: Concha
authors.initials: C
authors.lastname: Zamora
authors.affiliation: Department of Haematology, General Hospital Nuestra Señora del Prado, Talavera de la Reina, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Solano
mesh_terms: D000368:Aged; D001565:Benzoates / Q000627:therapeutic use; D015913:Chelation Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D000077588:Deferasirox; D019468:Disease Management; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D005293:Ferritins / Q000097:blood; D019983:Guideline Adherence; D006402:Hematologic Diseases / Q000628:therapy; D006801:Humans; D007501:Iron / Q000097:blood; D007502:Iron Chelating Agents / Q000627:therapeutic use; D019190:Iron Overload / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013030:Spain; D065227:Transfusion Reaction; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D007501:Iron; D000077588:Deferasirox