Impact of transfusion dependency and secondary iron overload on the survival of patients with myelodysplastic syndromes.

Transfusion dependency is an independent prognostic factor in myelodysplastic syndromes (MDS). The detrimental effect on survival is related to the severity of transfusion requirement and is more noticeable in low-risk patients. Elevated serum ferritin levels have a poor prognostic impact on the survival of transfusion-dependent patients with refractory anemias, and can adversely affect the outcome of patients with MDS receiving allogeneic stem-cell transplantation. Sequential measurements of serum ferritin are useful for measuring secondary iron overload in MDS patients. The implementation of non-invasive methods for assessing tissue iron and organ function should clarify the impact of iron-mediated organ damage on patients with MDS.