Do Recent Randomized Trial Results Influence which Patients with Myelodysplastic Syndromes Receive Iron Chelation?

Iron overload (IOL) in patients with myelodysplastic syndromes (MDS) is mainly attributable to chronic transfusion therapy. The importance of iron chelation therapy (ICT) in MDS has been a matter of debate. The Telesto study, the only randomized, placebo-controlled trial of ICT with deferasirox in MDS, showed improved event-free survival with ICT in patients with lower-risk MDS. Although Telesto was not powered to detect differences between deferasirox and placebo for single-event categories of the composite primary endpoint for event-free survival, results are consistent with the view that iron-related cardiac dysfunction is ameliorated by ICT in elderly patients with MDS.