Blood Reviews
Volume 23 , Pages S21-S25 , December 2009

Iron chelation therapy in MDS: what have we learnt recently?

  • Mathias Schmid

      Affiliations

    • Corresponding Author InformationCorresponding author. Mathias Schmid, PD, Dr. Med, Universitätsklinikum Ulm, Innere Medizin III, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Tel.: +49 731 500 45537; fax: +49 731 500 45515

References 

  1. Bennett JM , MDS Foundation's Working Group on Transfusional Iron Overload  . Consensus statement on iron overload in myelodysplastic syndromes . Am J Hematol . 2008;83:851–858
  2. Olivieri NF , Nathan DG , MacMillan JH , et al.   Survival in medically treated patients with homozygous β-thalassemia . N Engl J Med . 1994;331:574–578
  3. Leitch HA , Goodman TA , Wong KK , et al.   Improved survival in patient with myelodysplastic syndrome (MDS) receiving iron chelation therapy . Blood . 2006;108: abstract 249.
  4. Leitch HA . Improving clinical outcome in patients with myelodysplastic syndrome and iron overload using iron chelation therapy . Leuk Res . 2007;31(Suppl 3):S7–S9
  5. Takatoku M , Uchiyama T , Okamoto S , et al.   Retrospective nationwide survey of Japanese patients with transfusion-dependent MDS and aplastic anaemia highlights the negative impact of iron overload on morbidity/mortality . Eur J Haematol . 2007;78:484–487
  6. Rose C , Brechignac S , Vassilief D , et al.   Positive impact of iron chelation therapy (CT) on survival in regularly transfused MDS patients. A prospective analysis by the GFM . Blood . 2007;110: abstract 249.
  7. Alessandrino EP , Amadori S , Barosi G , et al.   Evidence- and consensus-based practice guidelines for the therapy of primary myelodysplastic syndromes. A statement from the Italian Society of Hematology . Haematologica . 2002;87:1286–1306
  8. Bowen D , Culligan D , Jowitt S , et al.   Guidelines for the diagnosis and therapy of adult myelodysplastic syndromes . Br J Haematol . 2003;120:187–200
  9. Gattermann N , Porter JB , Lopes LF , et al.   Consensus statement on iron overload in myelodysplastic syndromes . Hematol Oncol Clin North Am . 2005;19(Suppl 1):18–25
  10. Valent P , Krieger O , Stauder R , et al.   Iron overload in myelodysplastic syndromes (MDS) – diagnosis, management, and response criteria: a proposal of the Austrian MDS platform . Eur J Clin Invest . 2008;38:143–149
  11. Arrizabalaga B , del Cañizo C , Remacha A , et al.   Guía clínica de quelación del paciente con síndrome mielodisplásico . Haematologica . 2008;93(Suppl 1):3–10 [Spanish edition]
  12. Mittelman M , Lugassy G , Merkel D , et al.   Iron chelation therapy in patients with myelodysplastic syndromes: consensus conference guidelines . Isr Med Assoc J . 2008;10:374–376
  13. Suzuki T , Tomonaga M , Miyazaki Y , et al.   Japanese epidemiological survey with consensus statement on Japanese guidelines for treatment of iron overload in bone marrow failure syndromes . Int J Hematol . 2008;88:30–35
  14. Wells RA , Leber B , Buckstein R , et al.   Iron overload in myelodysplastic syndromes: a Canadian consensus guideline . Leuk Res . 2008;32:1338–1353
  15. National Comprehensive Cancer Network  . NCCN Clinical Practice Guidelines. Myelodysplastic Syndromes, v.2.2008 . Available at www.nccn.org
  16. Angelucci E , Brittenham GM , McLaren CE , et al.   Hepatic iron concentration and total body iron stores in thalassemia major . N Engl J Med . 2000;343:327–331
  17. Porter JB , Galanello R , Saglio G , et al.   Relative response of patients with myelodysplastic syndromes and other transfusion-dependent anaemias to deferasirox (ICL670): a 1-yr prospective study . Eur J Haematol . 2008;80:168–176
  18. List AF , Baer MR , Steensma D , et al.   Iron chelation with deferasirox (Exjade®) improves iron burden in patients with myelodysplastic syndromes (MDS) . Blood . 2008;112: abstract 634.
  19. Gattermann N , Schmid M , Della Porter M , et al.   Efficacy and safety of deferasirox (Exjade®) during 1 year of treatment in transfusion-dependent patient with myelodysplastic syndromes: results from EPIC trial . Blood . 2008;112: abstract 633.
  20. Cappellini MD , Porter J , El-Beshlawy A , et al.   Tailoring iron chelation by iron intake and serum ferritin: prospective EPIC study of deferasirox in 1744 patients with transfusion-dependent anemias . Haematologica . 2009; [Epub ahead of print].
  21. Schmid M , Guerci-Bresler A , Della Porta M , et al.   Efficacy and safety of deferasirox (Exjade®) in chelation-naive and previously chelated patients with transfusion-dependent myelodysplastic syndromes . Leuk Res . 2009;33(Suppl 1):S141–S142
  22. Gattermann N , Schmid M , Guerci-Bresler A , et al.   Reduction in serum ferritin is associated with improvement in liver transaminase levels during treatment with deferasirox (Exjade®) in iron-overloaded patients with myelodysplastic syndromes . Leuk Res . 2009;33(Suppl 1):S140–S141
  23. Porter JB , Cappellini MD , El-Bashlawy A , et al.   Effect of deferasirox (Exjade®)on labile plasma iron levels in heavily iron-overloaded patients with transfusion- dependent anemias enrolled in the large-scale, prospective 1-year EPIC trial . Blood . 2008;112: abstract 3881.
  24. Porter JB , Bowden D , Ganser A , et al.   Improved health-related quality of life in patient with haematological disorders receiving deferasirox (Exjade®) . Blood . 2008;112: abstract 1307.
  25. Porter JB , Bowden D , Ganser A , et al.   Satisfaction and adherence significantly improves in patients with β-thalassemia and myelodysplastic syndromes treated with deferasirox (Exjade®) . Blood . 2008;112: abstract 1306.
  26. Wimazal F , Nösslinger T , Baumgartner C , et al.   Deferasirox induces regression of iron overload in patients with myelodysplastic syndromes . Eur J Clin Invest . 2009;39:406–411
  27. Metzgeroth G , Dinter D , Schultheis B , et al.   Deferasirox in MDS patients with transfusion-caused iron overload – a phase-II study . Ann Hematol . 2009;88:301–310
  28. Rachmilewitz EA , Merkel D , Ghoti H , et al.   Improvement in oxidative stress parameters in MDS patients with iron overload treated with deferasirox . Blood . 2008;112: abstract 2675.
  29. Ghoti H , Fibach E , Merkel D , et al.   Decrease in intra- and extra-cellular free iron species and oxidative stress parameters and increase in serum and urinary hepcidin during treatment with deferasirox in iron-loaded patients with MDS . Haematologica . 2009;94: abstract 0797.
  30. Choi SO , Cho YS , Kim HL , Park JW . ROS mediate the hypoxic repression of the hepcidin gene by inhibiting C/EBPα and STAT-3 . Biochem Biophys Res Commun . 2007;356:312–317
  31. Messa E , Defilippi I , Roetto A , et al.   Deferasirox is the only iron chelation acting as a potent NF-κB inhibitor in myelodysplastic syndromes . Blood . 2008;112: abstract 2671.

PII: S0268-960X(09)70006-2

doi: 10.1016/S0268-960X(09)70006-2

Blood Reviews
Volume 23 , Pages S21-S25 , December 2009

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