Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
Preferred Abstract (Original):
Background: Anemia in patients
with cancer who are undergoing active therapy is commonly encountered
and may worsen quality of life in these patients. The effect of blood
transfusion is often temporary and may be associated with serious
adverse events. Erythropoiesis-stimulating agents are not effective in
30%–50% of patients and may have a negative effect on overall survival. Aims:
To assess the efficacy and feasibility of intravenous iron therapy in
patients with cancer who have non-iron-deficiency anemia and who are
undergoing treatment with chemotherapy without the use of
erythropoiesis-stimulating agents. Methods: Adult
patients with solid cancers and non-iron-deficiency anemia were
included. Ferric sucrose at a dose of 200 mg was given in short
intravenous infusions weekly for a total of 12 weeks. Hemoglobin level
was measured at baseline, every 3 weeks, and 2 weeks after the last iron
infusion (week 14). Adverse events related to intravenous iron were
prospectively reported. Results: Of 25 patients
included, 19 (76.0%) completed at least three iron infusions and 14
(56.0%) finished the planned 12 weeks of therapy. The mean hemoglobin
level of the 25 patients at baseline was 9.6 g/dL (median, 9.9 g/dL;
range, 6.9 g/dL10.9 g/dL). The mean change in hemoglobin level for the
15 patients who completed at least 9 treatments was 1.7 g/dL (median,
1.1 g/dL; range, −1.9 g/dL to 3.2 g/dL); it reached 2.1 g/dL (median,
1.3 g/dL; range, −0.2 g/dL to 4.6 g/dL; P = 0.0007) for the 14
patients who completed all 12 weekly treatments. Five (20.0%) patients
were transfused and considered as treatment failures. No
treatment-related adverse events were reported. Conclusion:
Intravenous iron treatment alone is safe and may reduce blood
transfusion requirements and improve hemoglobin level in patients with
cancer who are undergoing anticancer therapy. Further randomized studies
are needed to confirm these findings.