Most myelodysplastic syndrome (MDS) patients require regular transfusion therapy, an unavoidable side effect of which is iron overload. Valeria Santini, MD, University of Florence, Florence, Italy, outlines the aims, design and progress of the multicenter Itlalian trial (NCT03920657), which is investigating the clinical benefit and safety of early iron chelation with low dose deferasirox tablets in patients with MDS at the beginning of their transfusion journey. It is hoped that this will validate the possibility of continually suppressing tissue non-transferrin-bound-iron, labile plasma iron and oxidative stress; preventing iron accumulation and tissue damage. This interview took place at the American Society of Hematology (ASH) 2019 Annual Meeting and Exposition in Orlando, FL.