Deironing the spleen with luspatercept

In this issue of Blood, Denton et al1 show that luspatercept induces iron redistribution by reducing splenic iron without changing liver iron content in patients with 0-thalassemia (0-thal). This challenges the understanding that the iron content of the liver reflects total body iron and suggests that magnetic resonance imaging (MRI) scans should ideally include the liver and spleen to adequately monitor iron status in patients with iron-loading anemias treated with an erythroid maturation agent.