Iron Chelation Therapy Options for MDS

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Iron chelation therapy (ICT) is the primary strategy for reducing iron levels, explains Azra Raza, MD. The two oral ICTs available are deferiprone (Ferriprox) and deferasirox (Exjade). Deferiprone is approved as a second-line treatment for thalassemia and it is not often used in patients with myelodysplastic syndrome (MDS), Raza notes. As a result, deferasirox is generally the preferred therapy for patients with lower-risk MDS.

Deferasirox was the first oral drug approved by the FDA as a treatment for chronic iron overload, in 2005. In MDS, deferasirox is approved for patients with transfusion-dependent, lower-risk disease. In a study that included 341 patients with MDS, deferasirox reduced the median serum ferritin level by 35% in chelation-naïve patients and by 22% in previously chelated patients.

Raza also suggests the use of episodic ICT as another strategy to combat iron overload.