Durable Red Blood Cell Transfusion Independence in a Patient with an MDS/MPN Overlap Syndrome Following Discontinuation of Iron Chelation Therapy

Table 1

Characteristics of patients reported to have achieved sustained transfusion independence after stopping iron chelation therapy.

Case	Age	FAB or WHO diagnosis	Karyotype at diagnosis	Risk score	ICT	Duration of ICT	Time to TI (mo.)	Duration of TI (mo.)	Duration of TI after stopping ICT (mo.)	Other treatment	Reference
1	67	RA	del(11)(q22q24)	NR	DFO^1	30	52	NR	3–36^2	None reported	[29]
2	46	RA	Normal	NR	DFO	25	20	24+	3–36^2	None reported	[29]
3	41	RA	Normal	NR	DFO	20	36	20+	3–36^2	None reported	[29]
4	18	RAEB	Normal	NR	DFO	20	20	6+	3–36^2	None reported	[29]
5	65	MDS	+8	NR	DFO	15	50	NR	3–36^2	Hydrea^3	[29]
6	61	PMF	NR	Int.^4	DFX	20	5	36+	22+	None	[38]
7	63	RARS-T	Normal	Low^5	DFX	12	1.5	22	12+	EPO^6	Current report

AML, acute myelogenous leukemia; DFO, deferoxamine; DFX, deferasirox; Int., intermediate; FAB, French American British; hydrea, hydroxyurea; IPSS, International Prognostic Scoring System; ICT, iron chelation therapy; MDS, myelodysplastic syndrome; mo., months; MPN, myeloproliferative neoplasm; PMF, primary myelofibrosis; RA, refractory anemia; RAEB, refractory anemia with excess blasts; MDS, myelodysplastic syndromes; MPN, myeloproliferative neoplasm; NR, not reported; PMF, primary myelofibrosis; RARS-T, refractory anemia with ring sideroblasts and thrombocytosis; TI, transfusion independence; WHO, World Health Organization; +, indicates ongoing TI.
¹TI achieved 15 months after chelation was stopped. ²Duration of TI after stopping chelation for cases 1–5 was reported as a range only. ³Hydroxyurea was given after stopping chelation due to progression to AML. ⁴Dupriez score (Dupriez et al., 1996 [45]). ⁵IPSS score for MDS (Greenberg et al., 1997 [1]). ⁶No response to EPO.