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Chelation therapy in patients with iron overload due to frequent blood transfusions
open access
Abstract
The most common cause of iron overload (IO) are red blood cells transfusions, in less extend also increase of iron absorption from the gut due to ineffective erythropoiesis. IO leads to liver fibrosis/cirrhosis, cardiac dysfunction, diabetes and other endocrinopathies, changes in immunity worsening of survival in patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT). To prevent and delay complications associated with iron deposition in organs, iron chelation therapy with deferoxamine, deferiprone, deferasirox in monotherapy or in combination is recommended. Chelation therapy should be considered in transfussion-dependent patients diagnosed with inherited anemias (sickle cell anemia, thalassemias), low risk myelodysplastic syndromes, primary idiopatic myelofibrosis, with ferritin concentration higher than 1000 ng/mL or with iron depositions (confirmed in liver biopsy or nuclear magnetic resonance). Patients who have undergone allo-HSCT with persistent IO may also be candidates for treatment with iron chelators. We have more consistent data and evidences that chelating therapy improves the function of damaged organs, improves hematological response, and prolongs the survival of patients.
Abstract
The most common cause of iron overload (IO) are red blood cells transfusions, in less extend also increase of iron absorption from the gut due to ineffective erythropoiesis. IO leads to liver fibrosis/cirrhosis, cardiac dysfunction, diabetes and other endocrinopathies, changes in immunity worsening of survival in patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT). To prevent and delay complications associated with iron deposition in organs, iron chelation therapy with deferoxamine, deferiprone, deferasirox in monotherapy or in combination is recommended. Chelation therapy should be considered in transfussion-dependent patients diagnosed with inherited anemias (sickle cell anemia, thalassemias), low risk myelodysplastic syndromes, primary idiopatic myelofibrosis, with ferritin concentration higher than 1000 ng/mL or with iron depositions (confirmed in liver biopsy or nuclear magnetic resonance). Patients who have undergone allo-HSCT with persistent IO may also be candidates for treatment with iron chelators. We have more consistent data and evidences that chelating therapy improves the function of damaged organs, improves hematological response, and prolongs the survival of patients.
Keywords
iron overload, hiperferritinemia, deferoxamine, deferasirox, deferiprone
About this articleTitle
Chelation therapy in patients with iron overload due to frequent blood transfusions
Journal
Hematology in Clinical Practice
Issue
Article type
Review paper
Pages
1-13
Published online
2016-08-03
Page views
1041
Article views/downloads
11381
DOI
10.5603/Hem.2016.0003
Bibliographic record
Hematologia 2016;7(1):1-13.
Keywords
iron overload
hiperferritinemia
deferoxamine
deferasirox
deferiprone
Authors
Jadwiga Dwilewicz-Trojaczek
Anna Waszczuk-Gajda
