{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:46:04Z","timestamp":1789195564975,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diamond\u2013Blackfan Anemia Syndrome (DBAS) is a rare congenital anemia often requiring chronic red blood cell transfusions from infancy. Without appropriate chelation, iron overload develops early and may be severe; however, no data are available on chelation in patients under 3\u2009years of age. To address this, we conducted a retrospective, multicenter study collecting data from the French and Italian DBAS national registries. A total of 167 transfused DBAS patients were screened. Of these, 64 (38%) initiated chelation before the age of three (median: 18\u2009months). Indications for chelation were a serum ferritin \u2265\u2009500\u2009ng\/mL (median: 1340\u2009ng\/mL) and more than 10 transfusions. Deferasirox was the most frequently used chelator (63%), followed by deferoxamine (35%). Chelation was associated with a significant reduction in serum ferritin levels (\u221211% per year;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). At 5\u20136\u2009years of age, ferritin level was available for 28 patients: 43% had levels &lt;\u2009500\u2009ng\/mL, and none exceeded 2000\u2009ng\/mL. Liver iron concentration was assessed in 31\/64 patients (48%) at a median age of 3.2\u2009years; 45% showed severe overload at first evaluation. Among 22\u00a0patients who underwent cardiac magnetic resonance, no myocardial iron overload was detected. These real\u2010world data support the feasibility, tolerability, and effectiveness of chelation in transfusion\u2010dependent DBAS patients under 3\u2009years, allowing prevention of cardiac iron overload. Although derived from DBAS, these findings may inform the management of iron overload in infants and toddlers with other transfusion\u2010dependent anemias and support development of age\u2010specific chelation strategies.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70354","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T07:04:29Z","timestamp":1778483069000},"page":"1856-1865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Iron Overload in Infants and Toddlers With Diamond\u2013Blackfan Anemia Syndrome: A French\u2013Italian Study"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5861-9307","authenticated-orcid":false,"given":"Francesca","family":"Torchio","sequence":"first","affiliation":[{"name":"Department of Public Health and Pediatric Sciences University of Turin  Turin Italy"},{"name":"Department of Public Health and Pediatrics, Postgraduate School of Pediatrics University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Lecalvez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Immunology Robert Debr\u00e9 Academic Hospital, GHU AP\u2010HP Nord Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Garelli","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatric Sciences University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coralie","family":"Mallebranche","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Angers, Universit\u00e9 de Nantes CHU Angers, Inserm, CNRS, CRCI2NA, SFR ICAT  Angers France"},{"name":"Unit\u00e9 D'onco\u2010Immuno\u2010H\u00e9mato P\u00e9diatrique CHU D'Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Carando","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatric Sciences University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Pierre","family":"Castex","sequence":"additional","affiliation":[{"name":"Pediatric Oncology and Hematology Department, H\u00f4pital Des Enfants University Hospital Center of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Garnier","sequence":"additional","affiliation":[{"name":"Institut D'Hematologie et D'Oncologie Pediatrique Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-1744","authenticated-orcid":false,"given":"Marco","family":"Zecca","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology Fondazione IRCCS Policlinico San Matteo  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Aladjidi","sequence":"additional","affiliation":[{"name":"Paediatric Clinical Immunology, Pellegrin Hospital, CIC1401, INSERM CICP Bordeaux University Hospital  Bordeaux France"},{"name":"Centre de R\u00e9f\u00e9rence National Des Cytop\u00e9nies Auto\u2010Immunes de L'Enfant (CEREVANCE)  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Pediatric Oncohematology and Bone Marrow Transplant (BMT) Unit Children's Hospital, Spedali Civili  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Sterin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Immunology and Oncology La Timone Children's Hospital  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Licciardello","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology Unit, Department of Clinical and Experimental Medicine University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Sirvent","sequence":"additional","affiliation":[{"name":"Pediatric Haematology and Oncology Department CHU Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Sau","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Santo Spirito Hospital  Pescara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Marie","sequence":"additional","affiliation":[{"name":"French National Reference Center for Aplastic Anemia and PNH, CeRAMIC Saint\u2010Louis Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6453-6395","authenticated-orcid":false,"given":"Benedicte","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\u2010Oncology Jeanne de Flandre Hospital  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydie M.","family":"Da Costa","sequence":"additional","affiliation":[{"name":"French National Reference Center for Aplastic Anemia and PNH, CeRAMIC Saint\u2010Louis Hospital  Paris France"},{"name":"Paris\u2010Saclay University  Paris France"},{"name":"U1770 Inserm Gustave Roussy Institute, LABEX GR\u2010Ex  Villejuif France"},{"name":"Laboratory of Hematology Bic\u00eatre University Hospital  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Fagioli","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatric 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