Iron chelation therapy in myelodysplastic syndromes

Purpose. To understand how to appropriately recognize and manage iron overload with iron chelation therapy (ICT) in patients with myelodysplastic syndromes (MDS), evaluation of the role of different agents available for management of iron overload, including efficacy, safety, and economic considerations for transfusion-dependent patients with MDS, is provided. Summary. Patients with MDS have a high incidence of anemia, which often requires treatment. Supportive care measures such as red blood cell transfusions and erythroid colony stimulating factors are mainstays of therapy. Use of long-term transfusion therapy has limitations in patients with MDS due to the risk of developing iron overload. Strategies to manage iron overload include phlebotomy and ICT with agents such as deferoxamine and deferasirox. Data evaluating pharmacologic therapy for treatment of iron overload in patients with MDS suggest timely intervention can mitigate the morbidity associated with this clinical syndrome. Conclusion. Development of practical management strategies to implement and optimize ICT using deferoxamine and deferasirox will be important to provide optimal care for transfusion-dependent patients with MDS.