Combination therapy with DFO and deferiprone is an exciting new possibility for those patients inadequately chelated on either drug alone. ICL 670, a new oral iron chelation in early clinical trial, promises to expand further the range of possibilities for effective and safe iron chelation therapy for patients with TM and other iron-loaded transfusion-dependent or independent patients with severe refractory anemias. Whichever chelation regimen is chosen, patients must be closely monitored both for effectiveness of therapy, with particular attention to cardiac iron and function, and for toxic side effects of the chelating drug.