Iron overload is a potentially life-threatening consequence of multiple red-blood-cell transfusions. Here, we review factors affecting excess iron distribution and its damage to specific tissues, as well as mechanisms of oncogenesis by iron. Although consequences of transfusional iron overload are best described in thalassemia major and related inherited anemias, they are increasingly recognized in acquired conditions, such as myelodysplastic syndromes (MDS). Iron overload in MDS not only impacts on certain tissues, but may affect the clonal evolution of MDS through generation of reactive oxygen species. Iron overload may also influence hematopoietic-stem-cell-transplantation outcomes. Novel MRI methods for assessing body iron have impacted significantly on outcome in inherited anemias by allowing monitoring of iron burden and iron chelation therapy. This approach is increasingly being used in MDS and stem-cell-transplant procedures. Knowledge gained from managing transfusional iron overload in inherited anemias may be translated to general oncology, with potential for improved patient outcomes.
|Titolo:||New insights into transfusion-related iron toxicity : implications for the oncologist|
|Parole Chiave:||Acute myeloid leukemia; Chelation; Hematopoietic stem cell transplantation; Iron overload; Myelodysplastic syndromes; Oncogenesis; Thalassemia; Transfusion; Oncology; Hematology; Geriatrics and Gerontology|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
|Data di pubblicazione:||mar-2016|
|Data ahead of print / Data di stampa:||27-nov-2015|
|Digital Object Identifier (DOI):||10.1016/j.critrevonc.2015.11.017|
|Appare nelle tipologie:||01 - Articolo su periodico|