Patient selection: myelodysplasia
Indications for initiation of iron chelation therapy:
(1) transfusion-dependent (has received >= 2 units per month for > 1 year)
(2) serum ferritin > 1,000 ng/mL
(3) low-risk myelodysplasia (see below)
(4) life expectancy >= 12 months
(5) absence of comorbid conditions that would limit prognosis
(6) potential candidate for allograft
(7) patient with a need to preserve organ function
Low-risk myelodysplasia:
(1) low or intermediate-1 IPSS
(2) refractory anemia (RA), refractory anemia with ringed sideroblasts (RARS), 5q-
Chelation therapy is continued as long as the patient requires blood transfusion and as long as iron overload is clinically important.
