Tests and Tools for Detecting Iron Overload

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While there are multiple tests that can be used to monitor patients with myelodysplastic syndrome for iron overload, Azra Raza, MD, stresses that there is currently no single test that can accurately detect iron overload alone. For example, the serum ferritin level can be elevated for a variety of reasons, such as from an infection; thus, when considered alone, it is not an accurate indicator of iron overload.

Using a combination of tests (eg, number of transfusions [>20 units] and a chronically elevated serum ferritin level of >1000 mg) is likely the best option for detecting iron overload, Raza suggests. Other tools that can aid in predicting iron overload are labile plasma iron levels and T2-star MRIs. However, both need additional trials and assessment to document their validity and reliability. The T2-star MRIs are able to detect cardiac and hepatic iron overload, and though not readily available, may become the gold standard in the future, according to Raza.