Prevalence and treatment of anemia and secondary iron overload in patients with a myelodysplastic syndrome: Real-world data from a multicenter cohort study

Camiel L. M. de Roij van Zuijdewijn*, Peter E. Westerweel, Martin R. Schipperus, Johannes F. M. Pruijt, Arjan A. van de Loosdrecht, Aart Beeker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: anemia is the most common finding in patients with a myelodysplastic syndrome (MDS). Repetitive red blood cell (RBC) transfusions and disease-related low hepcidin levels induce secondary iron overload. Real-world data on the prevalence and treatment strategies of anemia and secondary iron overload in MDS patients, is limited. Methods: three years of data on MDS diagnosis, anemia and ferritin management was collected in 230 MDS patients from seven non-academic hospitals in the Netherlands. Descriptive statistics and linear mixed models were used to analyze the data. Results: transfusion dependent (TD) patients (n = 49) needed 1–3 RBC transfusions per month. Serum hemoglobin remained stable in both TD and transfusion-independent (TI) patients over 3 years. In the TD patients, serum ferritin increased 63 pmol/L/month. Overall, 19 (39%) were diagnosed with secondary hemochromatosis, of which 13 (68%) received chelation therapy with a heterogeneous response. Conclusions: mean hemoglobin remains stable over time in both TD and TI MDS patients. Approximately 40% of TD patients develop secondary hemochromatosis. Treatment and monitoring of secondary hemochromatosis as well as the response on chelation therapy vary substantially.
Original languageEnglish
JournalTransfusion Clinique et Biologique
Early online date2023
Publication statusE-pub ahead of print - 2023

Cite this