Efficacy and safety of iron chelator for transfusion-dependent patients with myelodysplastic syndrome: a meta-analysis

ABSTRACT

To systematically evaluate the efficacy and safety of iron chelators for transfusion-dependent patients with MDS. Thirteen cohort studies with 12,990 patients diagnosed with MDS were included in this study. According to m eta-analysis results transfusion-dependent MDS patients with secondary iron overload had a longer (HR = 0.52, 95%CI = 0.43–0.62, P < 0.001). Further subgroup analysis revealed a longer LFS (HR = 0.84, 95%CI = 0.76–0.93, P = 0.001) in MDS patients receiving iron chelators than in MDS patients not receiving iron chelators (HR = 0.52, 95%CI = 0.43–0.62, P < 0.001) and in patients with lower-risk MDS (HR = 0.50, 95%CI = 0.43–0.59, P < 0.001). Subgroup analysis of DFX showed that compared with patients not treated with iron chelators, the group receiving DFX monotherapy had significantly increased OS (HR = 0.43, 95%CI = 0.27–0.69, P < 0.001). In terms of tolerance, meta-analysis of binary variables in CAEs indicated that the occurrence of CAEs was significantly reduced by ICT (RR = 0.64, 95%CI = 0.57–0.71, P < 0.001).

KEYWORDS:

• Transfusion-dependent
• myelodysplastic syndrome
• iron chelator
• meta-analysis
• Deferasirox monotherapy
• overall survival
• leukaemia-free survival
• iron overload

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by Joint Funds for the Innovation of Science and Technology, Fujian Province [Grant/Award Number: 2017Y9051]; Fujian Medicine Innovation Program, [Grant/Award Number: 2017-CY-20 and 2018-CX-18]; Fujian Undergraduate Education and Teaching Reform Project [Grant/Award Number: FBJG20180225]; Key Project of Educational Reform in Fujian Medical University [Grant/Award Number: J18002].