Introduction to a How I Treat series on iron overload in hematologic disorders

Abstract

It has long been recognized that iron overload is toxic and that diagnosis and management of iron overload in patients with hematological disorders are complex and can be disease-specific. Associate Editor Thomas D. Coates presents a series that aims to deconvolute iron overload and provide advice on management. An overarching theme is that the magnitude and duration of exposure to reactive non–transferrin-bound iron, increased by ineffective erythropoiesis, transfusion, or upregulated iron absorption, determine tissue damage. Understanding this biology in a specific disease setting guides management. Coates reviews iron overload in transfusion-dependent hemoglobinopathies; Angelucci contributes insights on treating iron overload before, during, and after stem cell transplantation through discussion of 5 cases; and Leitch and Buckstein share their wisdom on treating iron overload in patients with myelodysplastic syndromes, outlining their approach in several common clinical scenarios.