What is your approach to screening a cancer survivor for iron overload, and what is your treatment of choice?

We check the ferritin level after completion of chemotherapy. If ferritin is >1,000 ng/ml, we recheck the level as it can be falsely elevated with inflammation/infection. If ferritin is >1,000, we obtain a liver MRI with iron quantification. If liver iron concentration (LIC) is > 5 mg/g dry weight, we initiate phlebotomy for 6-12 months, usually 12 months, and then repeat the liver MRI to ensure LIC is <5. We have at times also given Jadenu, which tends to work really well, but is contraindicated in patients with kidney dysfunction.

Excellent article on this topic:

Baskin-Miller et al., PMID 39096194