Iron toxicity – Its effect on the bone marrow
Alessandro Isidoria, , , Lorenza Borinb, , Elena Ellib, Roberto Latagliatac, Bruno Martinod, Giuseppe Palumboe, Federica Pilof, Federica Loscoccoa, Giuseppe Visania, , Paolo Cianciullig
https://doi.org/10.1016/j.blre.2018.04.004
Abstract
Excess iron can be extremely toxic for the body and may cause organ damage in the absence of iron chelation therapy. Preclinical studies on the role of free iron on bone marrow function have shown that iron toxicity leads to the accumulation of reactive
oxygen species, affects the expression of genes coding for proteins that regulate hematopoiesis, and disrupts hematopoiesis. These effects could be partially attenuated by iron-chelation treatment with deferasirox, suggesting iron toxicity may have a
negative impact on the hematopoietic microenvironment. Iron toxicity is of concern in transfusion-dependent patients. Importantly, iron chelation with deferasirox can cause the loss of transfusion dependency and may induce hematological responses,
although the mechanisms through which deferasirox exerts this action are currently unknown. This review will focus on the possible mechanisms of toxicity of free iron at the bone marrow level and in the bone marrow microenvironment.
Keywords
Aplastic anemia; Bone marrow microenvironment; Hematopoietic stem cell transplantation; Iron chelation; Iron toxicity; Myelodysplastic syndrome; Myelofibrosis
Corresponding author at: Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Via Lombroso 1, 61122 Pesaro, Italy.
© 2018 Published by Elsevier Ltd.
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