Department of Hematology/Medical Oncology, Emory University, Atlanta, GA 30322, USA.
Am J Health Syst Pharm. 2010 Apr;67(7 Suppl 2):S3-9. doi: 10.2146/ajhp090645.
The epidemiology of myelodysplastic syndromes (MDS) and iron overload, recent clinical findings that highlight the importance of actively managing iron overload, and recommendations for initiating and maintaining iron chelation therapy (ICT) are summarized.
MDS are a variety of hematological disorders with differing time courses. Disease morbidities are primarily due to cytopenias and evolution to acute myeloid leukemia. Iron overload is a serious complication in patients with MDS due to the long-term use of red blood cell transfusions in patients with symptomatic anemia. Clinical consequences of iron overload include end-organ damage and dysfunction, an increased frequency of transplant-related complications, and reduced survival rates. To prevent these complications, recommendations for initiating and maintaining ICT should be followed by clinicians caring for patients with MDS and iron overload.
As current therapeutic options for patients with MDS do not always reduce the transfusion burden, many patients will still need long-term transfusion therapy. Strategies for the management of iron overload in MDS should be considered early in the disease course and in appropriate patients in order to prevent negative clinical outcomes associated with excessive iron accumulation.
总结骨髓增生异常综合征（MDS）和铁过载的流行病学、近期突显积极管理铁过载重要性的临床发现，以及启动和维持铁螯合疗法（ICT）的建议。
MDS 是一组具有不同病程的血液系统疾病。疾病的病态主要是由于细胞减少和向急性髓系白血病的发展。由于患有症状性贫血的患者需要长期输注红细胞，因此 MDS 患者会出现严重的铁过载并发症。铁过载的临床后果包括终末器官损伤和功能障碍、移植相关并发症的发生率增加以及生存率降低。为了预防这些并发症，应遵循照顾 MDS 和铁过载患者的临床医生的建议，启动和维持 ICT。
由于 MDS 患者的当前治疗选择并不总是能减轻输血负担，因此许多患者仍将需要长期输血治疗。应在疾病早期并在适当的患者中考虑 MDS 中铁过载的管理策略，以防止与铁蓄积过多相关的负面临床结局。
