Oncology Pharmacy Services, Division of Hematology/Oncology, School of Medicine, Simon Cancer Center, Indiana University, Indianapolis 46202, USA.
Am J Health Syst Pharm. 2010 Apr;67(7 Suppl 2):S10-4; quiz S16. doi: 10.2146/ajhp090654.
To understand how to appropriately recognize and manage iron overload with iron chelation therapy (ICT) in patients with myelodysplastic syndromes (MDS), evaluation of the role of different agents available for management of iron overload, including efficacy, safety, and economic considerations for transfusion-dependent patients with MDS, is provided.
Patients with MDS have a high incidence of anemia, which often requires treatment. Supportive care measures such as red blood cell transfusions and erythroid colony stimulating factors are mainstays of therapy. Use of long-term transfusion therapy has limitations in patients with MDS due to the risk of developing iron overload. Strategies to manage iron overload include phlebotomy and ICT with agents such as deferoxamine and deferasirox. Data evaluating pharmacologic therapy for treatment of iron overload in patients with MDS suggest timely intervention can mitigate the morbidity associated with this clinical syndrome.
Development of practical management strategies to implement and optimize ICT using deferoxamine and deferasirox will be important to provide optimal care for transfusion-dependent patients with MDS.
了解如何通过铁螯合疗法（ICT）适当识别和管理骨髓增生异常综合征（MDS）患者的铁过载，评估用于管理铁过载的不同药物的作用，包括疗效、安全性和对依赖输血的 MDS 患者的经济学考虑。
MDS 患者贫血发生率高，常需治疗。支持性护理措施，如红细胞输注和红细胞生成刺激因子，是治疗的主要方法。由于存在发生铁过载的风险，长期输血治疗在 MDS 患者中的应用受到限制。管理铁过载的策略包括放血和 ICT，药物包括去铁胺和地拉罗司。评估 MDS 患者铁过载药物治疗的数据表明，及时干预可以减轻与该临床综合征相关的发病率。
制定实用的管理策略，实施和优化使用去铁胺和地拉罗司的 ICT，对于为依赖输血的 MDS 患者提供最佳护理将非常重要。
