Unraveling the mechanisms behind iron overload and ineffective hematopoiesis in myelodysplastic syndromes

•MDS is associated with ineffective hematopoiesis and peripheral blood cytopenias.•Red blood cell transfusion support can result in iron-induced toxicity.•Accumulation of reactive oxygen species caused by iron overload worsens hematopoiesis.•Iron chelation therapy can improve hematologic parameters and may prolong survival.•Other potential new strategies for reducing iron overload are under investigation.