The success of hematopoietic transplantation for hemoglobinopathies and hematological malignancies has been accompanied by the new challenge of how to identify, risk stratify, and treat iron overload and toxicity before and after transplantation. Substantial progress has been made in our understanding of iron metabolism and the pathophysiology of iron overload, making us aware that not only the total amount of iron in the body is important but also the effect of toxic iron species and duration of exposure are equally relevant. Challenges still remain in how to assess cellular and tissue damage and define the mechanism that may detrimentally affect the outcome of hematopoietic transplantation. In this article, I discuss the impact of iron toxicity in relation to the different phases of hematopoietic transplantation, before, during, and after, for both malignant and nonmalignant diseases. Different clinical scenarios and possibilities for therapeutic intervention are also outlined and discussed.
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IRON OVERLOAD IN HEMATOLOGIC DISORDERS|
January 23, 2025
How I manage iron overload in the hematopoietic cell transplantation setting
Emanuele Angelucci
Emanuele Angelucci
Hematology and Cellular Therapy, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Blood (2025) 145 (4): 372–382.
Article history
Submitted:
March 1, 2024
Accepted:
April 25, 2024
First Edition:
May 10, 2024
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Citation
Emanuele Angelucci; How I manage iron overload in the hematopoietic cell transplantation setting. Blood 2025; 145 (4): 372–382. doi: https://doi.org/10.1182/blood.2023022500
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January 23 2025
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