Iron overload in lower international prognostic scoring system risk patients with myelodysplastic syndrome receiving red blood cell transfusions: Relation to infections and possible benefit of iron chelation therapy

Leukemia Research
Colleen A C WongHeather A Leitch

Abstract

An increased incidence of infections and infectious mortality has been reported in myelodysplastic syndromes (MDS) patients receiving red blood cell (RBC) transfusions. We examined incidence of infections requiring antibiotics, antifungal or antiviral medications in transfused lower International Prognostic Scoring System (IPSS) risk MDS patients and whether this differed with iron chelation therapy (ICT). 138 transfused MDS patients were lower IPSS risk. 59 received ICT; median duration was 13 months. There was no significant difference between groups in neutrophil count at first RBC transfusion or first infection. Infections included: bacterial, n = 88; viral; fungal; and mycobacterial; n = 2 each. In ICT and non-ICT patients, respectively, infections were (number [%]): patients, 23 (40.0%) and 22 (27.8%); episodes (median [range]), 2 (1-6) and 2 (1-5); hospitalizations, 16 (27.1%) and 8 (10.1%); and deaths, 0 (0%) and 1 (1.3%), p = NS for all. Median overall survival (OS) from first RBC transfusion was superior in ICT patients, p = 0.01, and remained significant in a multivariate analysis (MVA), p = 0.003. Median time to first infection (TTI) was 27 and 7.8 months, respectively, p < 0.0001, and ICT remained significant for T...Continue Reading

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Citations

Feb 23, 2020·International Journal of Molecular Sciences·Giulio VernaMarcello Chieppa
Jan 13, 2021·Pharmaceuticals·Hana VotavovaMonika Belickova
Feb 25, 2020·Hematology/oncology Clinics of North America·Norbert Gattermann
Jul 11, 2020·HemaSphere·Francesca VinchiUwe Platzbecker
Jun 1, 2021·Critical Reviews in Oncology/hematology·Cecilia H Kim, Heather A Leitch

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