Haema 2016; 7(3): 321-328
by Maria Oikonomou
First Department of Pediatrics, Aristoteleion University of Thessaloniki, University General Hospital “Ippokrateion”, Thessaloniki, Greece
Abstract
The main reason for secondary iron overload is chronic transfusions, which is a major element in the management of hematologic patients. Chronic transfusions have been the basis in the treatment of thalassemia major patients for years, while patients suffering from other hemoglobinopathies like those with thalassemia intermedia or sickle cell disease are occasionally transfused. In addition, transfusions are used to treat patients with congenital or acquired bone marrow failure syndromes, like congenital dyserythropoietic anemia, Diamond-Blackfan anemia, aplastic anemia and myelodysplastic syndromes. In a number of these diseases, ineffective erythropoiesis results in increased iron absorption, aggravating iron overload secondary to transfusion therapy. Iron overload can lead to major complications, mainly involving the liver, the endocrine glands and the heart. Early diagnosis and regular follow up of iron overload are required in order to offer appropriate chelation. Imaging studies have replaced invasive methods for iron load assessment, contributing to optimal management of hematologic patients.