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Iron chelation may improve survival in MDS

Iron chelation therapy may significantly improve overall survival in heavily transfused patients with lower risk myelodysplastic syndrome (MDS)

A study published in the Leukaemia Research journal has concluded that iron chelation therapy (ICT) appears to improve survival in heavily transfused lower risk myelodysplastic syndromes (MDS) patients, and that adequate ICT was found significantly to improve overall survival in an independent manner.

In the multicentre study, 97 lower-risk (IPSS low and int-1 risk groups) regularly transfused MDS patients who received red blood transfusions, enrolled over a one-month period, were followed for 2.5 years. Data — on medical history, serum ferritin level at diagnosis and during follow up, and chelation therapy type (desferrioxamine deferasirox or deferiprone), tolerance, date of onset and termination, reasons for discontinuation, compliance, and impact on transfusion dependence and haematological characteristics — were collected and underwent multivariate analysis.

The team found that median survival for chelated patients was 10.3 years, compared with 4.4 years for non-chelated patients. This was a significant (p<0.0003) difference, more than doubling the overall survival in ICT-treated patients.

The positive effect of ICT on overall survival in other chronic anaemias, such as thalassemia major, is already established, though its benefits on MDS had previously only been suggested in small retrospective studies. However, current UK guidelines already recommend ICT in this patient population to avoid the possible toxic effects of iron overload (including damage to the heart, liver and endocrine system and death) caused by the repeated blood transfusions that are common among MDS patients. 

10th May 2010

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