PMID- 19365094
OWN - NLM
STAT- MEDLINE
DCOM- 20090721
LR  - 20230202
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Linking)
VI  - 14
IP  - 5
DP  - 2009 May
TI  - Managing iron overload in patients with myelodysplastic syndromes with oral 
      deferasirox therapy.
PG  - 489-96
LID - 10.1634/theoncologist.2008-0154 [doi]
AB  - Patients with myelodysplastic syndromes (MDS) often require chronic RBC 
      transfusions, which can lead to iron overload. Without adequate management, this 
      may cause progressive damage to hepatic, endocrine, and cardiac organs, 
      significantly affecting overall survival. Recent retrospective analyses have 
      suggested that iron chelation provides a survival advantage in iron-overloaded 
      patients with MDS who are given chelation therapy compared with those who are 
      not. Nonetheless, it is evident that iron overload in many patients with MDS is 
      not adequately managed. Clinical evaluation of the once-daily, oral iron chelator 
      deferasirox in MDS populations has indicated that it provides dose-dependent 
      reductions in body iron burden and is generally well tolerated, with a manageable 
      safety profile in adult and pediatric patients. The most common treatment-related 
      adverse events (AEs) included transient, mild-to-moderate gastrointestinal 
      disturbances and skin rash, which rarely required drug discontinuation and 
      resolved spontaneously in most cases. Adequate management of AEs and practical 
      approaches such as patient education and counseling are necessary to ensure that 
      patients remain compliant with therapy. Regular monitoring of serum ferritin 
      levels is key to identifying patients who require iron chelation therapy, and to 
      ensure maintenance of iron levels below the critical level of 1,000 microg/l. The 
      flexible dosing regimen of deferasirox allows dose adjustments to be made in 
      response to trends in serum ferritin, to changes in a patient's transfusional 
      iron intake, and to the objectives of treatment, allowing the full benefit of 
      transfusion therapy without the risks associated with iron overload.
FAU - Jabbour, Elias
AU  - Jabbour E
AD  - Department of Leukemia, University of Texas, MD Anderson Cancer Center, 1515 
      Holcombe Boulevard, Houston, TX 77030, USA. ejabbour@mdanderson.org
FAU - Garcia-Manero, Guillermo
AU  - Garcia-Manero G
FAU - Taher, Ali
AU  - Taher A
FAU - Kantarjian, Hagop M
AU  - Kantarjian HM
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090413
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
RN  - 0 (Benzoates)
RN  - 0 (Iron Chelating Agents)
RN  - 0 (Triazoles)
RN  - 9007-73-2 (Ferritins)
RN  - E1UOL152H7 (Iron)
RN  - V8G4MOF2V9 (Deferasirox)
SB  - IM
MH  - Administration, Oral
MH  - Benzoates/adverse effects/*therapeutic use
MH  - Deferasirox
MH  - Erythrocyte Transfusion/*adverse effects
MH  - Ferritins/blood
MH  - Humans
MH  - Iron/blood
MH  - Iron Chelating Agents/*therapeutic use
MH  - Iron Overload/*drug therapy
MH  - Myelodysplastic Syndromes/complications/*therapy
MH  - Triazoles/adverse effects/*therapeutic use
RF  - 53
EDAT- 2009/04/15 09:00
MHDA- 2009/07/22 09:00
CRDT- 2009/04/15 09:00
PHST- 2009/04/15 09:00 [entrez]
PHST- 2009/04/15 09:00 [pubmed]
PHST- 2009/07/22 09:00 [medline]
AID - theoncologist.2008-0154 [pii]
AID - 10.1634/theoncologist.2008-0154 [doi]
PST - ppublish
SO  - Oncologist. 2009 May;14(5):489-96. doi: 10.1634/theoncologist.2008-0154. Epub 
      2009 Apr 13.