Ironing out the details of iron overload in myelofibrosis: Lessons from myelodysplastic syndromes

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• 作者：Nicole Carreau^a ; Douglas Tremblay^a ; Michael Savona^b ; Marina Kremyanskaya^c ; John Mascarenhas^c ; ^{john.mascarenhas@mssm.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Iron overload ; Myelofibrosis ; Myelodysplastic syndrome ; Iron chelation therapy
• 刊名：Blood Reviews
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：30
• 期：5
• 页码：349-356
• 全文大小：500 K

文摘

Myelofibrosis (MF) and myelodysplastic syndrome (MDS) are hematopoietic stem cell disorders associated with cytopenias and red blood cell (RBC) transfusion dependence. Iron overload (IO) as a consequence of RBC transfusion dependence and its effect on outcomes in MF has not been formally studied. However, IO is a demonstrated poor prognostic feature in patients with MDS and congenital or acquired chronic anemias. Evidence that iron chelation therapy (ICT) reduces the deleterious effects of IO in MDS has led to speculation of benefit in MF. However, data supporting the use of ICT in MF is lacking. Neither disease has clear consensus guidelines for the use of ICT. Moreover, JAK–STAT inhibition, the cornerstone of MF treatment, often contributes to anemia and transfusional requirements. This manuscript reviews known and potential implications of IO in MF and highlights the need for prospective clinical investigations of ICT with consideration in the setting of JAK2 inhibitor therapy.