Iron Deficiency Anemia Is Common in Patients Receiving Chemotherapy

Background: Iron metabolism is impaired in patients with cancer and actively receiving chemotherapy. Patients with cancer on active chemotherapy suffer with decreased appetite , poor nutrition, mucositis, gastrointestinal mucosal damage, blood loss as well as anemia of chronic disease due to cytokines release such as Tumor Necrosis Factor, Interleukins and histamins.

The purpose of this abstract is to show single institution experience with patients actively receiving chemotherapy and admitted for various reasons and found to have anemia and particularly those patients that were admitted for red blood cell transfusion. Retrospective review of three hundred and fifty patients admitted in the last two years 2014-2015 for different reasons while on chemotherapy with anemia or mainly for blood transfusion. 55% females and 45% males. 77% had solid tumors and 23% with hematological malignancies. Median age 70 years. Thirty five percent 35% of solid tumors were of GI malignancies. Seventy five percenct of all patients had low iron saturation, low serum iron with normal to high total Iron Binding Capacity TIBC. Ferritin level was low in 60% of the patients. Ferritin is a phase reactive markers was elevated in 40% of patients. All patients with elevated ferritin were having low iron saturation with low serum iron and low or normal TIBC. Sixty five 65% of patients received blood transfusion. All patients with iron deficency received intravenous elemental iron support to saturate iron stores.

In conclusion: Iron deficiency anemia is very common in patient on active chemotherapy. With Intravenous elemental iron supplemet the requirement of less future red blood transfusion and improvement of hemoglobin levels were achieved in most of patients responding to chemotherapy. Need prospective analysis on patients diagnosed with malignancies and start receiving chemotherapy to prove the value of IV iron support and less requirement of red blood cell transfusion.