Cardiac iron overload in transfusion-dependent patients with myelodysplastic syndromes

Transfusion- dependent myelodysplastic (MDS) patients are prone to iron overload. We evaluated 43 transfused MDS patients with T2* magnetic resonance imaging scans. 81% had liver and 16.8% cardiac iron overload. Liver R2* (1000/T2*), but not cardiac R2*, was correlated with number of units transfused (r = 0.72, P < 0.0001) and ferritin (r = 0.53, P < 0.0001). The area under the curve of a time-ferritin plot was found to be much greater in patients with cardiac iron loading (median 53.7 x 10(5) Megaunits vs. 12.2 x 10(5) Megaunits, P = 0.002). HFE, HFE2, HAMP or SLC40A1 genotypes were not predictors of iron overload in these patients.