" The effectiveness of intravenous iron for iron deficiency anemia in gastrointestinal cancer patients: a retrospective study"

Abstract

Background:Knowledge of the role of intravenous iron without the use of additional erythropoietic stimulating agents in anemic cancer patients is limited. This study evaluated the effect of ferric carboxymaltose (FCM) in a group of digestive oncology (DIO) patients and aimed to differentiate therapy response according to different types of iron deficiency (ID) anemia.Methods:In this retrospective study, we identified DIO patients who were receiving FCM and had eligible baseline and follow-up hemoglobin (Hb) levels that did not require red blood cell transfusion. Subgroup analyses examined adequately versus inadequately treated patients and low (<100 µg/L) vs. high (>100 µg/L) baseline ferritin levels. Inadequate treatment was defined as administration of an insufficient dose of FCM, based on the modified Ganzoni formula.Results:A total of 414 patients were receiving FCM, of whom 41 were excluded because of transfusion and another 70 because of unknown or inadequate baseline iron status. Thus, the study group consisted of 303 patients. Follow-up serum levels were evaluated after a median of 4 weeks. Overall, the median change between baseline and follow-up Hb was 0.5 (interquartile range [IQR]: -0.1–1.6) g/dL. No significant difference in this change was found between the adequately and inadequately dosed groups. The median change in Hb was significantly greater in the low baseline ferritin group than in the high baseline ferritin group: 1.2 (IQR: 0.3–2.2) vs. 0.4 (IQR: -0.3–1.4) g/dL, respectively; P=0.004.Conclusions:Intravenous administration of iron in DIO patients with ID anemia leads to a significant increase in Hb. Moreover, differentiating between the types of ID anemia based on ferritin levels could be applied to predict therapy response, although better biomarkers are needed.

Role of intravenous iron in the treatment of anemia in patients with gastrointestinal tract tumors undergoing chemotherapy: a single-center, observational study

“…This study also revealed that low ferritin baseline levels seem to be a good predictor of therapy response. 12 Other study reported that cancer patients with baseline Hb levels up to 11.0 g/dL and serum ferritin up to 500 ng/mL benefited from FCM, which is in agreement with the baseline values observed in our study. 11 Moreover, the administration of intravenous iron to anemic cancer patients can significantly increase Hb concentrations, which may increase their quality of life and performance status and reduce the need for ESAs and/or blood transfusions.…”

Anemia and Iron Deficiency in Cancer Patients: Role of Iron Replacement Therapy

“…Patients in the FCM arm had a mean Hb increase significantly higher as compared to controls at week 8 [81]. IV FCM administration as monotherapy also effectively stimulated hematological response in a group of patients with gastrointestinal malignancies [57]. In agreement with Steinmetz et al, this trial suggested baseline ferritin levels <100 ng/mL as the predictor of response.…”

“…Thus, with respect to AID, while in otherwise normal individuals a serum ferritin level of <20–30 ng/mL is virtually diagnostic, in cancer patients a higher ferritin cut-off (e.g., <100 ng/mL) appears more reliable [54], as suggested in other chronic inflammatory conditions such as kidney disease or heart failure [55]. Moreover, some studies noted that a ferritin level of 100 ng/mL might be a good threshold to identify patients better responsive to IV iron therapy [56,57].…”

Therapeutic effects of antimicrobial peptide on malignant ascites in a mouse model

“…Bone marrow suppression and anemia, as indicated by a decrease in hemoglobin and red blood cells, are frequently observed in patients with ascites tumors ( 26 ). There is a high incidence of anemia in patients with gastrointestinal cancer ( 27 ). White blood cells, including neutrophils, lymphocytes and monocytes, are key cells of the immune system.…”