Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Suite D1B30 (Mayer 1B21), Boston, MA 02215, USA.
Curr Hematol Malig Rep. 2011 Jun;6(2):136-44. doi: 10.1007/s11899-011-0084-z.
Accumulation of excessive amounts of iron in vulnerable organs and tissues, together with elevated plasma and intracellular concentrations of reactive iron molecules, are likely to be harmful to some patients with myelodysplastic syndromes (MDS) who have received numerous red blood cell transfusions. But what is the real magnitude of risks related to iron overload in MDS, and how strong is the evidence that reducing total body iron and labile plasma iron through treatment with chelating drugs is beneficial to patients? Available data can be interpreted in different ways, and as a result, these topics continue to be areas of heated debate among physicians who care for patients with MDS. Using the traditional but rarely employed format of a classical dialogue, I explore here the potential dangers of iron overload and the risks and benefits of iron chelation therapy for patients with MDS.
在接受了多次红细胞输注的骨髓增生异常综合征 (MDS) 患者中，过多的铁在脆弱的器官和组织中蓄积，以及血浆和细胞内反应性铁分子浓度升高，可能对一些患者有害。但是，铁过载与 MDS 相关的风险有多大，以及通过使用螯合剂治疗来减少体内总铁和不稳定血浆铁对患者有益的证据有多强？可用的数据可以有不同的解释，因此，这些话题在治疗 MDS 患者的医生中仍然是激烈争论的领域。在这里，我使用传统但很少使用的经典对话格式，探讨 MDS 患者铁过载的潜在危险以及铁螯合治疗的风险和益处。
