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Treating Chronic Iron Overload
Whether of primary or secondary origins, chronic iron overload represents a serious threat to patients' long-term health and well-being. Guidelines exist for the diagnosis and management of iron overload in its most common presentations: patients with hereditary hemochromatosis or transfusion-dependent anemias including sickle cell disease, myelodysplastic syndromes, or thalassemia major. Common to all these guidelines is the diagnostic and prognostic value of serum ferritin >1000 mcg/L, which is associated with serious clinical sequelae in both hereditary hemochromatosis (1) and transfusional iron overload (2-4).
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Sickle cell disease
Learn more about when to begin managing iron overload in patients with sickle cell disease, and NHLBI recommendations for the management of iron overload in these patients.
Myelodysplastic syndromes
Learn more about when to begin managing iron overload in patients with myelodysplastic syndromes, and NCCN recommendations for the management of iron overload in these patients.
Thalassemia major
Learn more about when to begin managing iron overload in patients with thalassemia major, and TIF recommendations for the management of iron overload in these patients.
References
- (1) Morrison ED, Brandhagen DJ, Phatak PD, et al. Serum ferritin level predicts advanced hepatic fibrosis among U.S. patients with phenotypic hemochromatosis. Ann Intern Med. 2003;138:627-33.
- (2) Takatoku M, Uchiyama T, Okamoto S, et al. Retrospective nationwide survey of Japanese patients with transfusion-dependent MDS and aplastic anemia highlights the negative impact of iron overload on morbidity/mortality. Eur J Haematol. 2007;78:487-94.
- (3) Chapter 5: Iron Overload. Cappellini N, Cohen A, Eleftheriou A, Piga A, Porter J, eds. In: Guidelines for the Clinical Management of Thalassaemia: Thalassaemia International Federation; 2000:21-35.
- (4) National Heart, Lung, and Blood Institute. The Management of Sickle Cell Disease. 4th ed. Bethesda, Md: National Institutes of Health; 2002. NIH publication 02-2117.