骨髓增生异常综合征(myelodysplastic syndromes,MDS)患者自然病程中会出现输血依赖并发展为输血相关的铁过载,同时由于MDS红细胞无效造血,肠道加强膳食铁的吸收而加重铁过载.铁过载与MDS并发症、降低MDS生存期密切相关.因此,本文将阐述MDS输血依赖及铁过载的认识,特别关注作为不稳定铁的氧化还原活性存在形式的作用机制、铁过载通过氧化应激对MDS造血机能影响的机制及对MDS生存期及白血病转化风险的影响等问题.%Patients with myelodysplastic syndromes (MDS) become dependent on blood transfusions and develop into transfusional iron overload, which is exacerbated by increased absorption of dietary iron in response to ineffective erythropoiesis. However, it is uncertain whether there is an association among iron accumulation, clinical complications, and decreased likelihood of survival in MDS patients. Thereby our current understanding of the effects of transfusion dependency and iron overload in MDS are discussed. Particular emphasis should be placed on further characterizing the role of redox-active forms of labile iron and oxidative stress in iron overload, decreased life expectancy and increased risk of leukemic transformation in MDS patients with iron overload.
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