Yeh Su-Peng, Yang Yang-Sheng, Yao Chao-Yuan, Peng Ching-Tien
Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Hemoglobin. 2009;33(5):339-45. doi: 10.3109/03630260903212654.
Chronic blood transfusions are necessary for patients with hereditary anemia such as thalassemia, and for patients with myelodysplastic syndrome (MDS) who become anemic and transfusion-dependent. A common consequence of chronic transfusion is iron accumulation that can lead to organ damage. While there is general agreement regarding the value of iron chelation therapy to reduce the detrimental effects of iron overload in thalassemia major, the same is not true for MDS. The malignant nature of the disease and the relatively high cost of iron chelation therapy make cost-effectiveness an issue of great concern. Furthermore, the positive assessment of a drug's cost-effectiveness in one country does not necessarily justify its use in another country. More prospective studies are needed to identify the best iron chelator for patients with MDS as well as to identify those patients who will benefit most from iron chelation therapy.
对于患有遗传性贫血（如地中海贫血）的患者以及患有骨髓增生异常综合征（MDS）且出现贫血并依赖输血的患者而言，长期输血是必要的。长期输血的一个常见后果是铁蓄积，这可能导致器官损伤。虽然对于铁螯合疗法在减轻重型地中海贫血中铁过载的有害影响方面的价值已达成普遍共识，但在MDS中情况并非如此。该疾病的恶性本质以及铁螯合疗法相对较高的成本使得成本效益成为一个备受关注的问题。此外，一种药物在一个国家的成本效益的积极评估并不一定证明其在另一个国家也可使用。需要更多的前瞻性研究来确定MDS患者的最佳铁螯合剂，以及确定那些将从铁螯合疗法中获益最大的患者。
