Document Detail


Impact of iron overload and potential benefit from iron chelation in low-risk myelodysplastic syndrome.
MedLine Citation:
PMID:  24923296     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Myelodysplastic syndromes (MDS) are a group of heterogeneous clonal bone marrow disorders characterized by ineffective hematopoiesis, peripheral blood cytopenias, and potential for malignant transformation. Lower / intermediate risk MDS are associated with longer survival and high RBC transfusion requirements resulting in secondary iron overload. Recent data suggest that markers of iron overload portend a relatively poor prognosis and retrospective analysis demonstrates that iron chelation therapy is associated with prolonged survival in transfusion-dependent MDS patients. New data provides concrete evidence of iron's adverse effects on erythroid precursors in vitro and in vivo. Renewed interest in the iron field was heralded by the discovery of hepcidin, the main serum peptide hormone negative regulator of body iron. Evidence from β-thalassemia suggests that regulation of hepcidin by erythropoiesis dominates regulation by iron. Since iron overload develops in some MDS patients who do not require RBC transfusions, the suppressive effect of ineffective erythropoiesis on hepcidin may also play a role in iron overload. We anticipate that additional novel tools for measuring iron overload and a molecular mechanism-driven description of MDS subtypes will provide a deeper understanding of how iron metabolism and erythropoiesis intersect in MDS and improve clinical management of this patient population.
Authors:
Niraj Shenoy; Nishanth Vallumsetla; Eliezer Rachmilewitz; Amit Verma; Yelena Ginzburg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-12
Journal Detail:
Title:  Blood     Volume:  -     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Society of Hematology.
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