Definition of functional iron deficiency and intravenous iron supplementation – Author's reply

2016 ◽  
Vol 3 (11) ◽  
pp. e504-e505 ◽  
Author(s):  
Alhossain A Khalafallah
Keyword(s):  
Iron Deficiency ◽  
Iron Supplementation ◽  
Intravenous Iron ◽  
Functional Iron Deficiency ◽  
Definition Of ◽  
Intravenous Iron Supplementation

Randomized Trial of Intravenous Iron Supplementation in Patients With Chemotherapy-Related Anemia Without Iron Deficiency Treated With Darbepoetin Alfa

2008 ◽  
Vol 26 (10) ◽  
pp. 1619-1625 ◽  
Author(s):  
Paolo Pedrazzoli ◽  
Antonio Farris ◽  
Salvatore Del Prete ◽  
Filomena Del Gaizo ◽  
Daris Ferrari ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Supplementation ◽  
Intravenous Iron ◽  
Time Profile ◽  
Iron Group ◽  
Eligibility Criteria ◽  
Functional Iron Deficiency ◽  
Intention To Treat ◽  
Iv Iron ◽  
Hematopoietic Response

Purpose Unresponsiveness to erythropoiesis-stimulating agents, occurring in 30% to 50% of patients, is a major limitation to the treatment of chemotherapy-related anemia. We have prospectively evaluated whether intravenous iron can increase the proportion of patients with chemotherapy-related anemia who respond to darbepoetin. Patients and Methods Between December 2004 and February 2006, 149 patients with lung, gynecologic, breast, and colorectal cancers and ≥ 12 weeks of planned chemotherapy were enrolled from 33 institutions. Patients were required to have hemoglobin ≤ 11 g/L and no absolute or functional iron deficiency. All patients received darbepoetin 150 μg subcutaneously once weekly for 12 weeks and were randomly assigned to sodium ferric gluconate 125 mg intravenously (IV) weekly for the first 6 weeks (n = 73) or no iron (n = 76). Primary end point of the study was the percentage of patients achieving hematopoietic response (hemoglobin ≥ 12 g/dL or ≥ 2 g/dL increase). Results Hematopoietic response by intention-to-treat analysis was 76.7% (95%CI, 65.4% to 85.8%) in the darbepoetin/iron group and 61.8% (95%CI, 50.0% to 72.7%) in the darbepoetin group (P = .0495). Among patients fulfilling eligibility criteria and having received at least four darbepoetin administrations, hematopoietic responses in the darbepoetin/iron group (n = 53) and in the darbepoetin-only group (n = 50) were 92.5% (95% CI, 81.8% to 97.9%) and 70% (95% CI, 55.4% to 82.1%), respectively (P = .0033). Increase of hemoglobin during treatment period showed a time profile favoring darbepoetin/iron with statistically significant effect from week 5 on. The safety profile was comparable in the two arms. Conclusion In patients with chemotherapy-related anemia and no iron deficiency, IV iron supplementation significantly reduces treatment failures to darbepoetin without additional toxicity.

scholarly journals Usefulness of Reticulocyte Hemoglobin Equivalent in Management of Regular Hemodialysis Patients with Iron Deficiency Anemia

2016 ◽  
Vol 54 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Naomi Niari Dalimunthe ◽  
Abdurrahim Rasyid Lubis
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Intravenous Iron ◽  
Hemodialysis Patients ◽  
Deficiency Anemia ◽  
Dialysis Session ◽  
Early Predictor ◽  
Regular Hemodialysis ◽  
Intravenous Iron Supplementation

Introduction. Reticulocyte hemoglobin equivalent (RET-He) is a new parameter for evaluating iron status. This study aims to assess diagnostic value and investigate RET-He as early predictor of response to intravenous iron supplementation. Methods. Seventy-two regular hemodialysis patients at Adam Malik Hospital were studied from April to May 2011. RET-He was compared with conventional iron parameters for identification of iron deficiency. Fifteen patients with iron deficiency anemia were selected to receive 100 mg iron sucrose intravenous during every dialysis session (2x/weeks) for 4 weeks. Results. Receiver operating characteristic (ROC) curve for RET-He revealed the value of area under the curve was 0.818 (p < 0.0001). Using cutoff level 31.65 pg, RET-He showed 81.5% sensitivity and 61.6% specificity. Serum ferritin (r = 0.499, p < 0.0001) and transferrin saturation/ TSAT (r = 0.592, p<0.0001) were correlated to RET-He. Significant improvement in hemoglobin, hematocrit and RET-He were found after intervention (p = 0.023, p = 0.049 and p = 0.019, respectively). Conclusion. RET-He is a useful marker of iron deficiency and early predictor of response to intravenous iron supplementation in regular hemodialysis patients.

scholarly journals Gastric Siderosis and Ulceration from Intravenous Iron Supplementation Manifesting as Chronic Upper Gastrointestinal Bleeding: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Donald Ewing ◽  
Ava Brozovich ◽  
Ethan Burns ◽  
Gonzalo Acosta ◽  
Courtney Hatcher ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Gastrointestinal Bleeding ◽  
Iron Supplementation ◽  
Upper Gastrointestinal Bleeding ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Red Blood Cell Transfusions ◽  
Upper Gastrointestinal ◽  
Intravenous Iron Supplementation

Iron deficiency is the most common etiology of anemia worldwide and is often managed with varying methods of iron supplementation. Although rare, oral iron supplementation can perpetuate iron deficiency anemia by causing gastric ulceration and upper gastrointestinal bleeding in high-risk populations. However, this complication has not been previously described with intravenous iron supplementation. We present a case of a 63-year-old male with severe iron deficiency anemia on biweekly intravenous iron infusions and weekly packed red blood cell transfusions who presented with melena over several months. Upper endoscopy demonstrated a clean-based gastric body ulcer and nonbleeding gastric varices. Histology of the gastric ulcer was suggestive of iron-induced gastric mucosal injury. This case demonstrates that frequent utilization of intravenous iron and packed red blood cell transfusions may predispose certain patients to the development of iron-induced gastritis and ulceration.

scholarly journals Effects of Iron Supplementation on Erythropoietic Response in Patients with Cancer-Associated Anemia Treated by Means of Erythropoietic Stimulating Agents

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Torbjörn Karlsson
Keyword(s):  
Iron Supplementation ◽  
Randomized Clinical Trials ◽  
Intravenous Iron ◽  
Functional Iron Deficiency ◽  
Patients With Cancer ◽  
The Past ◽  
Esa Therapy ◽  
Erythropoietic Response ◽  
Intravenous Iron Supplementation

During the past decade, intravenous iron supplementation to ESA (erythropoiesis-stimulating agent) therapy has emerged as an option to augment hemoglobin response in anemic cancer patients. In this paper, the results of seven published randomized clinical trials assessing the role of iron supplementation to ESA therapy in the hematology/oncology setting will be discussed. The pathogenetic mechanisms behind functional iron deficiency, a major reason for ESA hyporesponsiveness in cancer, will also be described.

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