[Post transfusionnal iron overload]

Post transfusionnal iron overload is related to both a degree of RBC units transfused and excess intestinal absorption of Fe related to dyserythopoiesis. This condition is associated with high rates of morbidity and mortality, mainly of cardiac origin. Iron chelation therapy in patients with thalassemia who were effectively chelated has prevented or partially reversed some of these consequences. However the reference treatment by deferoxamine is strenuous and compliance is poor. Two oral iron chelators, deferiprone and deferasirox, provide potentially useful treatment for iron overload, both agents are relatively well tolerated (mainly deferasirox). They were at least as effective as DFO for decreasing iron burdens in comparative trials, and were associated with improved cardiac outcomes (for deferiprone). A new enthusiastic area for iron chelation with less burdensome treatments is open; however a long term follow up is required before giving up pumps and needles.