Abstract
The majority of patients with myelodysplastic syndromes (MDS) become transfusion-dependent during the course of disease and may thus develop transfusional iron overload. As a further contributor to iron overload there is increased absorption of dietary iron from the gut, as a consequence of ineffective erythropoiesis. Compared with thalassemia, it is less clear how frequent patients with MDS develop clinical complications of iron overload, and whether the accumulation of iron shortens their survival. This review aims to summarize our current knowledge of the detrimental effects of transfusional iron overload in MDS, point out the risks associated with ironinduced oxidative stress, describe the tools available for diagnosing iron overload, indicate the treatment options with currently available iron chelators, and discuss the measurement of labile plasma iron (LPI) as a tool to monitor the efficacy of iron chelation therapy.
Keywords: Iron overload, myelodysplastic syndromes, oxidative stress, non-transferrin-bound iron, labile plasma iron, iron chelation, dietary iron, transfusional iron overload, erythropoiesis, hemoglobin
Current Pharmaceutical Design
Title:Pathophysiological and Clinical Aspects of Iron Chelation Therapy in MDS
Volume: 18 Issue: 22
Author(s): Norbert Gattermann
Affiliation:
Keywords: Iron overload, myelodysplastic syndromes, oxidative stress, non-transferrin-bound iron, labile plasma iron, iron chelation, dietary iron, transfusional iron overload, erythropoiesis, hemoglobin
Abstract: The majority of patients with myelodysplastic syndromes (MDS) become transfusion-dependent during the course of disease and may thus develop transfusional iron overload. As a further contributor to iron overload there is increased absorption of dietary iron from the gut, as a consequence of ineffective erythropoiesis. Compared with thalassemia, it is less clear how frequent patients with MDS develop clinical complications of iron overload, and whether the accumulation of iron shortens their survival. This review aims to summarize our current knowledge of the detrimental effects of transfusional iron overload in MDS, point out the risks associated with ironinduced oxidative stress, describe the tools available for diagnosing iron overload, indicate the treatment options with currently available iron chelators, and discuss the measurement of labile plasma iron (LPI) as a tool to monitor the efficacy of iron chelation therapy.
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Cite this article as:
Gattermann Norbert, Pathophysiological and Clinical Aspects of Iron Chelation Therapy in MDS, Current Pharmaceutical Design 2012; 18 (22) . https://dx.doi.org/10.2174/1381612811209023222
DOI https://dx.doi.org/10.2174/1381612811209023222 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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