Myelodysplastic syndromes (MDSs) are a heterogeneous group of hematological disorders which are more common in the elderly and related to chronic anemia dependent on blood transfusions. Consequently, many of these patients develop iron overload which may lead to severe injury to tissues. Transfusions and chelation therapy, when indicated, are important for survival and to maintain the quality of life. Chelation therapy is indicated especially for MDS subtypes with a better prognosis and a sufficiently long survival to develop clinically relevant iron overload. Chelation therapy presents with some limitations in particular the long time required for deferoxamine infusion and the difficulties of patients to comply with treatment and to acquire an infusion pump. The clinical use of deferiprone, an oral chelator, is not indicated for MDS patients because of the risk of neutropenia and agranulocytosis. Deferasirox is a new oral chelator currently under clinical development that will probably be, in the future, an adequate option for MDS patients with iron overload. Additional studies in MDS patients are necessary to establish better diagnostic and chelation therapy criteria.
Myelodysplastic syndromes; supportive care; transfusion therapy; iron overload; chelation therapy
