Patients with
myelodysplastic syndrome (mds) experience clinical complications related to progressive marrow failure and have an increased risk of developing
acute myeloid leukemia. Frequent
red blood cell transfusion can lead to clinical
iron overload and is associated with decreased survival in mds patients.
Iron chelation therapy reduces markers of
iron overload and prevents end-organ damage. Here, we present the case of a patient with low-risk mds with transfusional
iron overload. He was treated for 2 years with an oral
iron chelator,
deferasirox, and after 12 months of treatment, he experienced a
hemoglobin increase of more than 50 g/L, becoming transfusion-independent. He has remained transfusion-independent, with a normal
hemoglobin level, for more than 2 years since stopping
chelation therapy. Hematologic and erythroid responses have previously been reported in mds patients treated with
iron chelation. The durability of our patient's response suggests that
iron chelation might alter the natural history of mds in some patients.