Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.
Division of Hematology, AOU Careggi, University of Florence, Firenze, Italy.
Crit Rev Oncol Hematol. 2014 Jul;91(1):64-73. doi: 10.1016/j.critrevonc.2014.01.006. Epub 2014 Jan 24.
Iron overload remains a concern in MDS patients especially those requiring recurrent blood transfusions. The consequence of iron overload may be more relevant in patients with low and intermediate-1 risk MDS who may survive long enough to experience such manifestations. It is a matter of debate whether this overload has time to yield organ damage, but it is quite evident that cellular damage and DNA genotoxic effect are induced. Iron overload may play a critical role in exacerbating pre-existing morbidity or even unmask silent ones. Under these circumstances, iron chelation therapy could play an integral role in the management of these patients. This review entails an in depth analysis of iron overload in MDS patients; its pathophysiology, effect on survival, associated risks and diagnostic options. It also discusses management options in relation to chelation therapy used in MDS patients and the impact it has on survival, hematologic response and organ function.
铁过载仍然是 MDS 患者的一个关注点，尤其是那些需要反复输血的患者。铁过载的后果在低危和中危-1 风险 MDS 患者中可能更为相关，他们可能有足够的时间来经历这些表现。目前仍存在争议的是，这种过载是否有时间导致器官损伤，但很明显，细胞损伤和 DNA 遗传毒性作用是被诱导的。铁过载可能在加重现有疾病甚至揭示隐匿性疾病方面发挥关键作用。在这种情况下，铁螯合疗法可以在这些患者的治疗中发挥重要作用。这篇综述深入分析了 MDS 患者的铁过载问题；其病理生理学、对生存的影响、相关风险和诊断选择。它还讨论了与 MDS 患者使用的螯合疗法相关的治疗选择，以及它对生存、血液学反应和器官功能的影响。
