Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Hematology
Published in: International Journal of Hematology 1/2008

Open Access 01-07-2008 | Progress in Hematology

Iron chelation therapy in the myelodysplastic syndromes and aplastic anemia: a review of experience in South Korea

Author: Jong Wook Lee

Published in: International Journal of Hematology | Issue 1/2008

Login to get access

Abstract

Emerging clinical data indicate that transfusion-dependent patients with bone marrow-failure syndromes (BMFS) are at risk of the consequences of iron overload, including progressive damage to hepatic, endocrine, and cardiac organs. Despite the availability of deferoxamine (DFO) in Korea since 1998, data from patients with myelodysplastic syndromes, aplastic anemia, and other BMFS show significant iron overload and damage to the heart and liver. The recent introduction of deferasirox, a once-daily, oral iron chelator, may improve the availability of iron chelation therapy to iron-overloaded patients, and improve compliance in patients who may otherwise find adherence to the DFO regimen difficult.
Literature
1.
2.
Alessandrino EP, Amadori S, Cazzola M, et al. Myelodysplastic syndromes: recent advances. Haematologica. 2001;86:1124–57.PubMed
3.
4.
Jeong DC, Kang IJ, Koo HH, et al. Epidemiology and clinical outcomes in children with aplastic anemia in Korea: retrospective study. Korean J Pediatr Hematol-Oncol. 2004;11:137–52.
5.
Lee HW, Choi JM, Kang SY, et al. Clinical characteristics and prognosis according to the classification of myelodysplastic syndrome. Korean J Med. 2006;70:253–60.
6.
Lee JJ, Kim HJ, Chung IJ, et al. Comparisons of prognostic scoring systems for myelodysplastic syndromes: a Korean multicenter study. Leuk Res. 1999;23:425–32.CrossRefPubMed
7.
Lee JH, Lee JH, Shin YR, et al. Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome. Leukemia. 2003;17:305–13.CrossRefPubMed
8.
Germing U, Strupp C, Kundgen A, et al. No increase in age-specific incidence of myelodysplastic syndromes. Haematologica. 2004;89:905–10.PubMed
9.
10.
Schafer AI, Cheron RG, Dluhy R, et al. Clinical consequences of acquired transfusional iron overload in adults. N Engl J Med. 1981;304:319–24.CrossRefPubMed
11.
Malcovati L, Della 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.CrossRefPubMed
12.
Jaeger M, Aul C, Sohngen D, Germing U, Schneider W. Secondary hemochromatosis in polytransfused patients with myelodysplastic syndromes. Beitr Infusionsther. 1992;30:464–8.PubMed
13.
Cho D, Lee J, Sohn S, et al. Transfusion-related iron overload in Korea. Korean J Hematol. 2007;42(Suppl 2):11–2.
14.
Takatoku M, Uchiyama T, Okamoto S, et al. Retrospective 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.CrossRefPubMed
15.
Ohnuma K, Toyoda Y, Nishihira H, et al. [Detection of early cardiac dysfunction in patients with transfusion-dependent aplastic anemia and chronic iron overload in childhood. Stress-velocity relation as a sensitive index by echocardiography]. Rinsho Ketsueki. 1996;37:825–32.PubMed
16.
Malcovati L, la Porta MG, Cazzola M. Predicting survival and leukemic evolution in patients with myelodysplastic syndrome. Haematologica. 2006;91:1588–90.PubMed
17.
Strasser SI, Kowdley KV, Sale GE, McDonald GB. Iron overload in bone marrow transplant recipients. Bone Marrow Transplant. 1998;22:167–73.CrossRefPubMed
18.
Armand P, Kim HT, Cutler CS, et al. Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation. Blood. 2007;109:4586–8.CrossRefPubMedPubMedCentral
19.
Altes A, Remacha AF, Sarda P, et al. Early clinical impact of iron overload in stem cell transplantation. A prospective study. Ann Hematol. 2007;86:443–7.CrossRefPubMed
20.
Evens AM, Mehta J, Gordon LI. Rust and corrosion in hematopoietic stem cell transplantation: the problem of iron and oxidative stress. Bone Marrow Transplant. 2004;34:561–71.CrossRefPubMed
21.
Oguchi T, Kitano K, Kobayashi H, Saito H, Okamoto S, Kiyosawa K. Aplastic anemia complicated with secondary hemochromatosis after allogenic bone marrow transplantation. Rinsho Ketsueki. 1995;36:1188–92.PubMed
22.
Bin JH, Yoo YK, Kim SY, et al. The effects of multiple transfusion on the outcomes of bone marrow transplantation from HLA-matched sibling donor in patients with severe aplastic anemia. Korean J Pediatr Hematol-Oncol. 2003;10:30–8.
23.
Anderson LJ, Holden S, Davis B, et al. Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J. 2001;22:2171–9.CrossRefPubMed
24.
St Pierre TG, Clark PR, Chua-anusorn W, et al. Non-invasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood. 2005;105:855–61.CrossRefPubMed
25.
Olivieri NF, Brittenham GM. Iron-chelating therapy and the treatment of thalassemia. Blood. 1997;89:739–61.PubMed
26.
27.
Gattermann N. Guidelines on iron chelation therapy in patients with myelodysplastic syndromes and transfusional iron overload. Leuk Res. 2007;31 Suppl 3:S10–5.CrossRefPubMed
28.
Leitch HA. Improving clinical outcome in patients with myelodysplastic syndrome and iron overload using iron chelation therapy. Leuk Res. 2007;31 Suppl 3:S7–9.CrossRefPubMed
29.
Rose C, Brechignac S, Vassilief D, et al. Positive impact of iron chelation therapy (CT) on survival in regularly transfused MDS patients. A prospective analysis by the GFM. Blood. 2007;110(11):abst 249.
30.
Jensen PD, Jensen IM, Ellegaard J. Desferrioxamine treatment reduces blood transfusion requirements in patients with myelodysplastic syndrome. Br J Haematol. 1992;80:121–4.CrossRefPubMed
31.
Del Rio GJ, Fernandez LC, Batlle Fonrodona FJ. Desferrioxamine in the treatment of myelodysplastic syndromes. Haematologica. 1997;82:639–40.
32.
Jensen PD, Heickendorff L, Pedersen B, et al. The effect of iron chelation on haemopoiesis in MDS patients with transfusional iron overload. Br J Haematol. 1996;94:288–99.CrossRefPubMed
33.
Jensen PD, Jensen FT, Christensen T, Nielsen JL, Ellegaard J. Relationship between hepatocellular injury and transfusional iron overload prior to and during iron chelation with desferrioxamine: a study in adult patients with acquired anemias. Blood. 2003;101:91–6.CrossRefPubMed
34.
Jensen PD, Jensen FT, Christensen T, Eiskjaer H, Baandrup U, Nielsen JL. Evaluation of myocardial iron by magnetic resonance imaging during iron chelation therapy with deferrioxamine: indication of close relation between myocardial iron content and chelatable iron pool. Blood. 2003;101:4632–9.CrossRefPubMed
35.
Porter J, Galanello R, Saglio G, et al. Relative response of patients with myelodysplastic syndromes and other transfusion-dependent anaemias to deferasirox (ICL670): a 1-year prospective study. Eur J Haematol. 2008;80:168–76.PubMedPubMedCentral
36.
Payne K, Desrosiers MP, Proskorovsky I, Ishak K, Baladi JF. Ferritin levels, non-compliance and adverse events in relation to infused iron chelation therapy in an international cohort of patients from actual practice. Haematologica. 2006;91 Suppl 1:abst 1059.
37.
Desferal. Basic patient leaflet. Novartis. 1998.
38.
Cappellini MD. Overcoming the challenge of patient compliance with iron chelation therapy. Semin Hematol. 2005;42:S19–21.CrossRefPubMed
39.
Miyata Y, Kajiguchi T, Saito M, Takeyama H. Development of arterial thrombus of Mucorales hyphae during deferoxamine therapy in a patient with aplastic anemia in transformation to myelodysplastic syndrome. Rinsho Ketsueki. 2000;41:129–34.PubMed
40.
Spraul CW, Schicketanz C, Lang GE. Ocular side effects of deferoxamine therapy in aplastic anemia with transfusion-induced hemochromatosis. Klin Monatsbl Augenheilkd. 1996;209:31–6.CrossRefPubMed
41.
Multinational pharmaceutical firms launch seven new drugs. Pharma Koreana. 2008;17:15.
42.
List AF, Esposito J, Decker J, et al. Iron parameters in 84 MDS patients enrolled in a deferasirox (Exjade®, ICL670) multicenter trial. Blood. 2006;108(11):abst 4847.
43.
Gattermann N, Schmid M, Vassilieff D, et al. Severe iron overload in patients with myelodysplastic syndromes enrolled in a large study of deferasirox (Exjade®, ICL670). Leuk Res. 2007;31 Suppl 1:S109–10 (Abstract P129).CrossRef
44.
List AF, Baer MR, Steensma D, et al. Deferasirox (ICL670; Exjade®) reduces serum ferritin (SF) and labile plasma iron (LPI) in patients with myelodysplastic syndromes (MDS). Blood. 2007;110(11):abst 1470.
45.
Cappellini MD, Vichinsky E, Galanello R, Piga A, Williamson P, Porter JB. Long-term treatment with deferasirox (Exjade®, ICL670), a once-daily oral iron chelator, is effective in patients with transfusion-dependent anemias. Blood. 2007;110:abst 2777.
46.
47.
48.
Bowen D, Culligan D, Jowitt S, et al. Guidelines for the diagnosis and therapy of adult myelodysplastic syndromes. Br J Haematol. 2003;120:187–200.CrossRefPubMed
49.
Alessandrino EP, Amadori S, Barosi G, et al. Evidence- and consensus-based practice guidelines for the therapy of primary myelodysplastic syndromes. A statement from the Italian Society of Hematology. Haematologica. 2002;87:1286–306.PubMed
50.
Gattermann N, Porter J, Lopes LF, Seymour J. Consensus statement on iron overload in myelodysplastic syndromes. Hematol Oncol Clin North Am. 2005;19 Suppl 1:18–25.
Metadata
Title
Iron chelation therapy in the myelodysplastic syndromes and aplastic anemia: a review of experience in South Korea
Author
Jong Wook Lee
Publication date
01-07-2008
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 1/2008
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-008-0117-0

Other articles of this Issue 1/2008

International Journal of Hematology 1/2008 Go to the issue

Images in Hematology

Disseminated diffuse large B cell lymphoma of bone on PET scan

Letter to the Editor

Karyotypically independent clones with del(11q) and trisomy 10 in acute myeloid leukemia: trisomy 10 may appear as an additional change

Case Report

Donor cell leukemia after allogeneic peripheral blood stem cell transplantation: a case report and literature review

Rapid Communication

Visual disturbance comorbid with hallucination caused by voriconazole in the Japanese population

Original Article

Phagocytosis of co-developing neutrophil progenitors by dendritic cells in a culture of human CD34+ cells with granulocyte colony-stimulating factor and tumor necrosis factor-α

Original Article

Thrombopoietin (TPO) regulates HIF-1α levels through generation of mitochondrial reactive oxygen species
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits