While clinical benefits of iron chelation therapy (ICT) in red blood cell transfusion dependent (RBC TD) hereditary anemias such as beta-thalassemia major are incontrovertible, the evidence supporting a similar benefit in patients with TD myelodysplastic neoplasms (MDS) and iron overload (IOL) is sometimes debated. MDS presents later in life, has a limited repertoire of life extending therapies, and patients may have comorbidities acting as competing causes of death. However, …