Patients with myelodysplastic syndrome (MDS) should be tested frequently for iron overload, a common, toxic side effect of repeated red blood cell transfusions. Patients with serum ferritin levels of 1,000 ng/ml to 2,000 ng/ml should be treated with iron chelation therapy, according to a new consensus statement, developed following a conference in Japan earlier this year. The new guidelines, published in a July 2005 supplement to Hematology-Oncology Clinics of North America, offer the first recommendations on the treatment of iron overload in these patients.