MYELODYSPLASTIC SYNDROME AND IRON OVERLOAD: RESULTS OF SCREENING EXAMINATION OF 289 PATIENTS


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Abstract

The data for screening examination of iron metabolism in 289 patients with myelodysplastic syndrome (MDS) are presented. Screening was aimed to identify the category of patients who may benefit from chelator therapy. The data analysis suggests that iron overload is one of the characteristic symptoms in patients with low risk MDS, especially in the case of donor red blood cells transfusion. Thereby, chelator therapy should be an integral part of treatment in patients with MDS. Administration of iron chelators for patients with MDS should be preceded by analyses of the clinical and laboratory indices, including the number of packed red blood cell unit transfusions, serum ferritin level, and transferrin saturation level.

References

  1. Абдулкадыров К.М. Гематология. Новейший справочник по гематологии. М.-СПб., 2005. 928 с.
  2. Steensma DP, Bennet JM. The myelodysplastic syndromes: diagnosis and treatment. Mayo Clin Proc 2006;81:104-130.
  3. Natchkamp K, Kuendgen A, Hilderbrandt B, et al. Hematological characteristic of patients with myelodysplastic syndromes in the light of WHO 2008 proposals. Blood 2008;112(Abstr.):1658.
  4. Sekeres MA, Schoonen WM, Kantarjian H, et al. Characteristics of US patients with myelodysplastic syndromes: results of six cross-sectional physician surveys. J Natl Cancer Inst 2008;100:1542-51.
  5. Cazzola M, Malcovati L. Risk-adapted treatment of myelodysplastic syndromes. Hematology Education. Education program for the 14th congress of the European Hematology Association. 2009;181-87.
  6. Sekeres MA. Treatment of MDS: something old, something new, something borrowed. Hematology (Am Soc Hematol Educ Program) 2009:656-63.
  7. Porter JB. Concepts and goals in the management of transfusional iron overload. Am J Hematol 2007;82:1136-39.
  8. Remacha AF, Arrizabalaga B, Canizo C, et al. Iron overload and chelation therapy in patients with low-risk myelodysplastic syndromes with transfusion requirements. Ann Hematol 2010;89:147-54.
  9. Bullen JJ, Rogers HJ, Spalding PB, et al. Iron and infection: the heart of the matter. FEMS Immunol Med Microbiol 2005;43:325-30.
  10. Malcovati L, Porta MG, Pascutto C, et al. Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria: a basis for clinical decision making. J Clin Oncol 2005;23:7594-603.
  11. Sanz G, Nomdedeu B, Such E, et al. Independent impact of iron overload and transfusion dependency on survival and leukemic evolution in patients with myelodysplastic syndrome. Blood 2008;112(Abstr.):640.
  12. Rollison DE, Howlader N, Smith MT, et al. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs. Blood 2008;112:45-52.
  13. Leitch H, Vickars LM. Supportive care and chelation therapy in MDS: are we saving lives or just lowering iron? Hematology (Am Soc Hematol Educ Program) 2009:664-72.
  14. Rose C, Brechignac, Vassilief D, et al. Does iron chelation therapy improve survival in regulatory transfused lower risk MDS patients? A multicenter study by the GFM. Leuk Res 2010 (available online).
  15. Schmid M. Iron chelation therapy in MDS: what have we learnt recently? Blood Rev 2009;23(Suppl. 1):S21-S25.
  16. Armand P, Kim H, Cutler C, et al. Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation. Blood 2007;109:4586-88.
  17. Maradei SC, Maiolini A, Azevedo AM, et al. Serrum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation. Blood 2009;114:1270-75.
  18. Witte T, Brand R, Biezen A, et al. Allogeneic stem cell transplantation for the patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival. Br J haematol 2009;146:627-36.
  19. Gattermann N. The treatment of secondary hemochromatosis. Dtsch Arztebl Int 2009;106:499-504.
  20. Witte T. Oral presentation. MDS Iron Forum. Amsterdam. 12 April 2007.
  21. Pullarkat V. Objectives of iron chelation therapy in myelodysplastic syndromes: more than meets the eyes? Blood 2009;114:5251-55.
  22. Gattermann N. Overview of guidelines on iron chelation in patients with myelodysplastic syndrome. Int J Hematol 2008;88:24-29.
  23. Bennett JM. Consensus statement on iron overload in myelodysplastic syndromes. Am J Hematol 2008;83:868-61.
  24. Sekeres MA. The epidemiology of myelodysplastic syndrome. Hematol Oncol Clin N Am 2010;24:287-94.
  25. Wu WC, Rathore SS, Wang Y, et al. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001;345:1230-36.
  26. Kao JM, McMillan A, Greenberg P. International MDS risk analysis workshop IMRAW)/IPSS reanalyzed: impact of cytopenias on clinical outcomes in myelodyspalstic syndromes. Am J Hematol 2008;83:765-70.
  27. Goldberg S. Novel treatment options for transfusional iron overload in patients with myelodysplastic syndromes. Leuk Res 2007;31(Suppl. 3):16-22.
  28. Oliva EN, Dimitrov BD, Benedetto F, et al. Hemoglobin level threshold for cardiac remodeling and quality of life in myelodysplastic syndromes. Leuk Res 2005;29:1217-19.
  29. Malcovati L, Germing U, Kuendgen A, et al. Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodyspalstic syndromes. J Clin Oncol 2007;25:3503-10.
  30. Kantarjian H, O'Brien S, Ravandi F, et al. Proposal for a new risk model in myelodysplastic syndrome that accounts for events not considered in the original International Prognostic Scoring System. Cancer 2008;113:1351-61.
  31. Malcovati L. Red blood cell transfusion and iron chelation in patients with myelodyspalstic syndromes. Clinic Lympoma Myeloma Leukem 2009;9(Suppl. 3):305-11.
  32. Takatoku M, Uchiyama T, Okamoto S, et al. Retrospective nationwide nationwide survey of Japanese patients with transfusion-dependent MDS and aplastic anemia highlights the negative impact of iron overload on morbidity/mortality. Eur J Haematol 2007;78:487-94.
  33. Malcovati L, Porta M, Pascutto C, et al. Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria: a basis for clinical decision making. J Clin Oncol 2005;23:7594-603.
  34. Cazzola M, Malcovati L. Myelodysplatic syndromes - coping with ineffective hematopoiesis. N Engl J Med 2005;352:536-38.
  35. Cappellini MD, Porter J, El-Beshlawy A, et al. Tailoring iron chelation by iron intake and serum ferritin: the prospective EPIC study of deferasirox in 1774 patients with transfusion-dependent anemias. Haematologica 2010;95:557-66.
  36. Anderson GJ. Mechanisms of iron loading and toxicity. Am J Hematol 2007;82:1128-31.
  37. Cortelezzi A, Cattaneo C, Cristiani S, et al. Non-ransferrin-bound iron in myelodysplastic syndromes: a marker of ineffective erythropoiesis? Hematol J 2000;1:153-58.
  38. Piga A, Longo F, Duca L, et al. High nontransferrin bound iron levels and heart disease in thalassemia major. Am J Hematol 2009;84:29-33.

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