Unraveling the mechanisms behind iron overload and ineffective hematopoiesis in myelodysplastic syndromes.

Abstract:

:Myelodysplastic syndromes (MDS) are a group of clonally-acquired blood disorders characterized by ineffective hematopoiesis leading to cytopenias. Red blood cell transfusions are an important component of supportive care in patients with MDS. Prolonged exposure to transfusions can lead to iron overload, which results in iron-induced toxicity caused by the production of reactive oxygen species (ROS). ROS accumulation has detrimental effects also on hematopoietic stem cells and may contribute to MDS progression. The observation that iron chelation improves hematologic parameters and reduces transfusion dependence further indicates that iron overload impairs hematopoiesis. Over the past decade, the mechanisms regulating iron homeostasis and the complex interplay between iron overload and toxicity, ineffective hematopoiesis, and transformation to leukemia have become clearer. In this narrative review, we provide an overview of recent findings pertaining to iron overload in patients with MDS and its effects on hematopoiesis. We also briefly discuss the position of chelation therapy in the context of the new developments.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Angelucci E,Cianciulli P,Finelli C,Mecucci C,Voso MT,Tura S

doi

10.1016/j.leukres.2017.10.001

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

108-115

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(17)30538-6

journal_volume

62

pub_type

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