New Trends in Iron Chelation: Impacting Outcomes

The availability of the effective, well-tolerated, and convenient, once-daily oral iron chelation therapy, deferasirox, has the potential to change clinical practice in a number of ways. It is possible that the outcome of patients who are currently receiving chelation therapy could be improved by freeing them from the burden of frequent, intravenous infusions of deferoxamine (DFO) and thereby improving long-term compliance. In addition, the ease of treatment may make treatment accessible to patients who currently do not receive iron chelation therapy. The potential of deferasirox therapy is illustrated in two “typical” clinical cases. One outlines a patient with β-thalassemia who is struggling to comply with DFO or DFO/deferiprone combination therapy and is consequently failing therapy and susceptible to the serious clinical sequelae of iron overload. The other is a patient with myelodysplastic syndrome who is transfusion-dependent and chelation-naïve, initiating therapy for the first time.