{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:34:59Z","timestamp":1791920099654,"version":"4.3.4"},"reference-count":93,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T00:00:00Z","timestamp":1529020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,10,15]]},"abstract":"<jats:p>Myelodysplastic syndromes (MDS) encompass a heterogeneous group of clonal hematopoietic stem cell disorders characterized by a broad clinical spectrum related to ineffective hematopoiesis leading to unilineage or multilineage cytopenias, with a high propensity for transformation to acute myeloid leukemia. Iron overload has been recently identified as one of the important conditions complicating the management of these diverse disorders. The accumulation of iron is mainly related to chronic transfusions; however, evidence suggests a possible role for ineffective erythropoiesis and increased intestinal absorption of iron, related to altered hepcidin and growth differentiation factor\u201015 levels in the development of hemosiderosis in patients with MDS. In addition to its suggested role in the exacerbation of ineffective erythropoiesis, multiple reports have identified a prognostic implication for the development of iron overload in patients with MDS, with an improvement in overall survival after the initiation of iron chelation therapy. This review includes a detailed discussion of iron overload in patients with MDS whether they are undergoing supportive therapy or curative hematopoietic stem cell transplantation, with a focus on the mechanism, diagnosis, and effect on survival as well as the optimal management of this highly variable complication.<\/jats:p>","DOI":"10.1002\/cncr.31550","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T14:02:36Z","timestamp":1529071356000},"page":"3979-3989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Iron overload in patients with myelodysplastic syndromes: An updated overview"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6457-7819","authenticated-orcid":false,"given":"Nour M.","family":"Moukalled","sequence":"first","affiliation":[{"name":"Department of Internal Medicine American University of Beirut, Naef K. Basile Cancer Institute  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuad A.","family":"El Rassi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University School of Medicine, Winship Cancer Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally N.","family":"Temraz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine American University of Beirut, Naef K. Basile Cancer Institute  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali T.","family":"Taher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine American University of Beirut, Naef K. Basile Cancer Institute  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1042\/BJ20101825"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00008.2013"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.12.4406"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00227.2005"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.25.2395"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1104742"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1309\/LMF28S2GIMXNWHMM"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-02-139915"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1777"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI25683"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2008.09.012"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm1629"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-12-195503"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2996"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2008.12.012"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbamcr.2012.05.010"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1042\/BJ20071474"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcmd.2015.06.003"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2004.10.003"},{"key":"e_1_2_4_21_1","first-page":"101","article-title":"Diagnostics, classification and treatment of myelodysplastic syndromes: Guidelines of the Polish Experts Group","volume":"41","author":"Dwilewicz\u2010Trojaczek J","year":"2010","journal-title":"Acta Haematol Pol"},{"key":"e_1_2_4_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-03-209262"},{"key":"e_1_2_4_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"e_1_2_4_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-420489"},{"key":"e_1_2_4_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(07)70459-9"},{"key":"e_1_2_4_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V112.11.640.640"},{"key":"e_1_2_4_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08749.x"},{"key":"e_1_2_4_28_1","doi-asserted-by":"crossref","first-page":"634a","DOI":"10.1182\/blood.V112.11.634.634","article-title":"Iron chelation with deferasirox (Exjade) improves iron burden in patients with myelodysplastic syndromes (MDS) [abstract]","volume":"112","author":"List AF","year":"2008","journal-title":"Blood"},{"key":"e_1_2_4_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02820.x"},{"key":"e_1_2_4_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20980"},{"key":"e_1_2_4_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06695.x"},{"key":"e_1_2_4_32_1","first-page":"758","article-title":"Detection of hepcidin in transfusion dependent myelodysplastic syndrome patients and its clinical significance [in Chinese]","volume":"32","author":"Qin Y","year":"2011","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"e_1_2_4_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2014.01.016"},{"key":"e_1_2_4_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0023109"},{"key":"e_1_2_4_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1839-5"},{"key":"e_1_2_4_36_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-03-563221"},{"key":"e_1_2_4_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20995"},{"key":"e_1_2_4_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2013.07.008"},{"key":"e_1_2_4_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2012.11.005"},{"key":"e_1_2_4_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13277-013-1294-x"},{"key":"e_1_2_4_41_1","first-page":"253294","article-title":"Durable red blood cell transfusion independence in a patient with an MDS\/MPN overlap syndrome following discontinuation of iron chelation therapy","volume":"2015","author":"Kochhar H","year":"2015","journal-title":"Case Rep Hematol."},{"key":"e_1_2_4_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-012-1594-z"},{"key":"e_1_2_4_43_1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V118.21.611.611","article-title":"High rate of erythroid response during iron chelation therapy in a cohort of 105 patients affected by hematologic malignancies with transfusional iron overload: an Italian multicenter retrospective study [abstract]","volume":"118","author":"Cilloni D","year":"2011","journal-title":"Blood"},{"key":"e_1_2_4_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1795.x"},{"key":"e_1_2_4_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.2009.01131.x"},{"key":"e_1_2_4_46_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.016824"},{"key":"e_1_2_4_47_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.2.680"},{"key":"e_1_2_4_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(13)70287-X"},{"key":"e_1_2_4_49_1","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1182\/blood.V112.11.2685.2685","article-title":"Iron overload and haematopoiesis in MDS: does blood transfusion promote progression to AML?","volume":"112","author":"Chan L","year":"2008","journal-title":"Blood"},{"key":"e_1_2_4_50_1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V122.21.959.959","article-title":"Iron chelation therapy could rapidly reduce oxidative DNA damage in CD34\u2009+\u2009hematopoietic cells before decrease of serum ferritin level [abstract]","volume":"122","author":"Kobune M","year":"2013","journal-title":"Blood"},{"key":"e_1_2_4_51_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.22299"},{"key":"e_1_2_4_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3512"},{"key":"e_1_2_4_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2017.10.001"},{"key":"e_1_2_4_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-010-1091-1"},{"key":"e_1_2_4_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-012-1048-3"},{"key":"e_1_2_4_56_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.01.7038"},{"key":"e_1_2_4_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2011.07.007"},{"key":"e_1_2_4_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2013.04.025"},{"key":"e_1_2_4_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2013.11.004"},{"key":"e_1_2_4_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2012.04.006"},{"key":"e_1_2_4_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2009.12.004"},{"key":"e_1_2_4_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13053"},{"key":"e_1_2_4_63_1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V110.11.1469.1469","article-title":"Improved leukemia\u2010free and overall survival in patients with myelodysplastic syndrome receiving iron chelation therapy: a subgroup analysis [abstract]","volume":"110","author":"Leitch HA","year":"2007","journal-title":"Blood"},{"key":"e_1_2_4_64_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2008.262"},{"key":"e_1_2_4_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.09.006"},{"key":"e_1_2_4_66_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.77"},{"key":"e_1_2_4_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-016-2802-z"},{"key":"e_1_2_4_68_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-03-212282"},{"key":"e_1_2_4_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704628"},{"key":"e_1_2_4_70_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22909"},{"key":"e_1_2_4_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.08.006"},{"key":"e_1_2_4_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23188"},{"key":"e_1_2_4_73_1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V126.23.386.386","article-title":"The extent of labile plasma iron (LPI) predicts for non\u2010relapse\u2010mortality (NRM) in AML and MDS patients with systemic iron overload undergoing allogenic stem cell transplantation: results of the prospective, German\u2010Austrian Allive Trial [abstract]","volume":"126","author":"Wermke M","year":"2015","journal-title":"Blood"},{"key":"e_1_2_4_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2017.03.002"},{"key":"e_1_2_4_75_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2011.1.443"},{"key":"e_1_2_4_76_1","doi-asserted-by":"publisher","DOI":"10.3109\/03630260903346676"},{"key":"e_1_2_4_77_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05104.x"},{"key":"e_1_2_4_78_1","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.2822"},{"key":"e_1_2_4_79_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1345.045"},{"key":"e_1_2_4_80_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S61540"},{"key":"e_1_2_4_81_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.94"},{"key":"e_1_2_4_82_1","doi-asserted-by":"publisher","DOI":"10.3109\/03630269.2011.578515"},{"key":"e_1_2_4_83_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2007.00985.x"},{"key":"e_1_2_4_84_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-008-0588-3"},{"key":"e_1_2_4_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2010.03.009"},{"key":"e_1_2_4_86_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.048546"},{"key":"e_1_2_4_87_1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V120.21.425.425","article-title":"Deferasirox chelation therapy in transfusion dependent MDS patients: final report from the Gimema MDS0306 prospective trial [abstract]","volume":"120","author":"Angelucci E","year":"2012","journal-title":"Blood"},{"key":"e_1_2_4_88_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.34.1222"},{"key":"e_1_2_4_89_1","first-page":"57","article-title":"Deferasirox reduces oxidative stress in patients with transfusion dependency","volume":"5","author":"Saigo K","year":"2013","journal-title":"J Clin Med Res"},{"key":"e_1_2_4_90_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2013.1617"},{"key":"e_1_2_4_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2013.07.021"},{"key":"e_1_2_4_92_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1994.tb01323.x"},{"key":"e_1_2_4_93_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24668"},{"key":"e_1_2_4_94_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.133348"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.31550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.31550","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.31550","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.31550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T01:58:01Z","timestamp":1761875881000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.31550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,15]]},"references-count":93,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2018,10,15]]}},"alternative-id":["10.1002\/cncr.31550"],"URL":"https:\/\/doi.org\/10.1002\/cncr.31550","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,15]]},"assertion":[{"value":"2018-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}