Fig. 1.

Markov model structure. Patients can become transfusion independent due to erythropoiesis-stimulating agent + granulocyte colony-stimulating factor (represented by dashed arrows). Cardiac complications can occur in any of the transfusion-dependent states, and diabetes mellitus and hepatic complications can occur in the TD-CF state (indicated by italicised text). Once complications have been experienced, they remain for the rest of the patient’s life. The absorbing state is death. The cycle length and time horizon are 28 days and 20 years, respectively. AML acute myeloid leukaemia, C chelation, CF chelation failure, NC no chelation, TI transfusion independence, TD transfusion dependence