Japanese epidemiological survey with consensus statement on Japanese guidelines for treatment of iron overload in bone marrow failure syndromes

Abstract

Many patients with bone marrow failure syndromes need frequent transfusions of red blood cells, and most of them eventually suffer from organ dysfunction induced by excessively accumulated iron. The only way to treat transfusion-induced iron overload is iron chelating therapy. However, most patients have not been treated effectively because daily/continuous administration of deferoxamine is difficult for outpatients. Recently, a novel oral iron chelator, deferasirox, has been developed, and introduction of the drug may help many patients benefit from iron chelation therapy. In this review, we will discuss the current status of iron overload in transfusion-dependent patients, and the development of Japanese guidelines for the treatment of iron overload in Japan, which were established by the National Research Group on Idiopathic Bone Marrow Failure Syndromes in Japan.

Fig. 1

Relationship between serum ferritin and total number of red blood cell units. [3] Modified with permission from Takatoku et al. Eur J Haematol. 2007;78:487–494. ^©2007 Blackwell Publishing

Fig. 2

Relationship between serum transaminase abnormality and serum ferritin levels. [3] Modified with permission from Takatoku et al. Eur J Haematol. 2007;78:487–494. ^©2007 Blackwell Publishing

Fig. 3

A flow chart for the treatment of transfusion-dependent iron overload