On the 3rd of November 2020, Marlijn Hoeks has successfully defended her PhD Thesis titled: Red blood cell transfusions in hemato-oncological patients - don’t iron out the consequences. Her thesis focussed on red blood cell transfusion (RBCT) strategies and monitoring and management of iron overload in patients with hematological malignancies. The MDS-RIGHT project activities and the EUMDS Registry data have been vital for various chapters in her thesis.

First Marlijn summarized and analysed the current RBC transfusion strategies based on available literature and a survey. Next she analysed the relation between RBCT administrations and various iron parameters. Also, the effect of iron chelation therapy on clinical outcome in lower-risk myelodysplastic syndrome (MDS) patients was evaluated. The main conclusions from her thesis can be summarized as following:

• A restrictive RBCT policy for intensively treated hemato-oncological patients is safe while it potentially reduces the risk of side effects and the costs.
• Lower-risk MDS patients are prone to the development of toxic iron species due to either chronic RBCT or the presence of ring sideroblasts which causes ineffective erythropoiesis.
• Toxic iron species are associated with a reduced overall and progression-free survival.
• Iron chelation therapy improves overall survival and hematopoiesis in transfused MDS patients

Marlijn has also described some future perspectives regarding the RBC transfusion strategies and estimates, indicating that important information will be gained on the treatment of iron overload/iron toxicity in patients with hematological malignancies in the coming years. This may lead to an improvement in the treatment in one of the most overlooked transfusion-associated side-effect, namely iron overload.

Marlijn has published a blog regarding the RBC transfusion practices on the MDS-Europe website.

We congratulate Marlijn Hoeks with the wonderful achievement of obtaining her PhD degree and are very happy that this project was able to aid her in her research questions.