Diagnosis and treatment of transfusion-related iron overload
10.5124/jkma.2022.65.10.662
- Author:
Hawk KIM
1
Author Information
1. Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Publication Type:Continuing Education Column
- From:Journal of the Korean Medical Association
2022;65(10):662-672
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Iron overload is frequently found in transfused patients with chronic anemia and congenital hemochromatosis. Iron toxicity adversely affects organs, including the heart, liver, and endocrine glands. Iron chelation helps patients with transfusion-related iron overload improve organ dysfunction and prolong survival.Current Concepts: Iron overload is classified into primary and secondary causes. Acquired causes of secondary iron overload include ineffective erythropoiesis, chronic transfusion, and chronic liver diseases. The effectiveness of iron chelation therapy in reducing or maintaining body iron has been demonstrated in many studies of patients with transfusion-induced anemias. Deferasirox, a once-daily oral iron chelator for adult and pediatric patients with transfusion-induced iron overload, is available in Korea. The initial daily dose of deferasirox recommended by Korean guidelines is 20 mg/kg body weight, taken on an empty stomach at least 30 minutes before meals. Serum ferritin levels should be maintained below 1,000 ng/mL.Discussion and Conclusion: Iron chelation therapy should be considered when a patient has undergone large red blood cell transfusions, and there is evidence of organ iron overload to improve organ dysfunction and survival.
