[Iron overload and iron chelation therapy in transfusion-dependent patients]

Many patients with bone marrow failure need repetitive transfusion of red blood cells and most of them finally suffer from organ dysfunction induced by excessively accumulated iron. The only way to treat iron overload caused by blood transfusion is iron chelation therapy. But most patients have not been treated sufficiently, because optimal administration of deferoxamine, the only iron chelator available in Japan, is difficult for many reasons. Recently, a novel oral iron chelator, deferasirox has been developed, and it is expected to improve chelation therapy in Japan in the near future. In this review, I will discuss the current and future status of iron overload and iron chelation therapy in transfusion-dependent patients. I will also introduce a proposed guideline for the diagnosis and treatment of iron overload in Japan.