Groupe Francophone des Myélodysplasies, France.
Blood Rev. 2009 Dec;23 Suppl 1:S15-9. doi: 10.1016/S0268-960X(09)70005-0.
Anaemia is prevalent in patients with myelodysplastic syndromes (MDS), and most patients with MDS receive regular red blood cell transfusions, which can lead to iron overload. Some patients may already have iron overload before transfusions begin, as a result of ineffective erythropoiesis. Iron overload has been linked to hepatic, cardiac, and endocrine dysfunction, although its exact contribution to cardiac failure and other complications is difficult to determine due to the advanced age of MDS patients and the prevalence of comorbidities. In addition, in patients with lower-risk MDS, a high serum ferritin level has been associated with an increased risk of leukaemic evolution independent of other prognostic factors, possibly related in part to the accumulation of free iron radicals. Finally, iron overload has been associated with poorer outcome after allogeneic stem cell transplantation and possibly with increased risk of infection. Thus, iron overload may negatively influence survival in patients with MDS, especially those with lower-risk disease. Iron chelation therapy may be beneficial in these patients.
贫血在骨髓增生异常综合征（MDS）患者中很常见，大多数 MDS 患者需要定期输注红细胞，这可能导致铁过载。一些患者在开始输血前可能已经存在铁过载，这是由于无效的红细胞生成。铁过载与肝、心和内分泌功能障碍有关，尽管由于 MDS 患者年龄较大和合并症的普遍存在，铁过载对心力衰竭和其他并发症的确切贡献难以确定。此外，在低危 MDS 患者中，血清铁蛋白水平升高与白血病演变的风险增加有关，这种风险独立于其他预后因素，这可能部分与游离铁自由基的积累有关。最后，铁过载与异基因造血干细胞移植后的不良预后相关，并且可能与感染风险增加相关。因此，铁过载可能会对 MDS 患者的生存产生负面影响，尤其是那些低危疾病的患者。铁螯合疗法可能对这些患者有益。
