Table 2.

Guidelines for the treatment of iron overload in myelodysplastic syndromes.

Guidelines	Transfusion status	Serum ferritin level (ng/ml)	Patient profile	Ref.
Italian	Received ≥ 20 RBC units	NS	IPSS low or INT-1 IPSS INT-2 or high, undergoing alloHSCT	[96]
UK	Received 25 RBC units	NS	Pure sideroblastic anemia del(5q)	[97]
Canada	Transfusion dependent	>1000	IPSS low or INT-1 IPSS INT-2 or high undergoing alloHSCT WHO RA, RARS and del-5q Life expectancy >1 year	[32]
MDS Foundation	Received 2 RBC units/month for ≥1 year	>1000	IPSS low or INT-1 WHO RA, RARS and del-5q No erythroid response to primary therapy Undergoing alloHSCT Life expectancy >1 year	[22]
NCCN	Received >20 RBC units	>2500	IPSS low or INT-1	[98]
Spanish	Transfusion dependent	>1000	IPSS low or INT-1 WPSS very low, low or INT Spanish Prognostic Index Low-risk	[99]
Israeli	Received 20–25 RBC units	>1000	IPSS low or INT-1 Life expectancy >1 year Undergoing alloHSCT	[100]
Japanese	Received >40† Japanese RBC units; Received >2 RBC units for ≥ 6 months	>1000	Life expectancy >1 year	[101]
Austrian	Transfusion dependent, >2 RBC units/month	>2000	Life expectancy >2 years	[102]

^†Equivalent to 20 western RBC units.

alloHSCT: Allogeneic hematopoietic stem cell transplant; del-5q: Deletion of long arm of chromosome 5; DFO: Deferoxamine; DFX: Deferasirox; IPSS: International Prognostic Scoring System; NR: Not reported; NS: Not stated; RA: Refractory anemia; RBC: Red blood cell; SF: Serum ferritin.

Adapted from [83].