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Intravenous Iron as an Alternative to Blood Transfusion in Cancer Patients: A Single Center Experience.

The American journal of hospice & palliative care
April 16, 2025
Ian Yeung et al. (6 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the efficacy and safety of intravenous iron in improving anemia and reducing transfusion requirements in cancer patients, particularly those receiving supportive care alone.

Results Summary

IV iron significantly increased hemoglobin levels (from 7.6 g/dL to 9.3 g/dL by day 60) and reduced transfusion requirements by 55% overall (62% in supportive care patients), with minimal adverse reactions (1.1%).

Population

Cancer patients receiving palliative care, including those on supportive care alone, at an integrated oncology center in Hong Kong.

Effective Dosage

Not specified

Duration

Follow-up periods included days 28 and 60, with transfusion data assessed up to 12 weeks.

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
IV iron
increase
mean Hb
cancer patients with anemia
from 7.6 g/dL at baseline to 8.8 g/dL by day 28
increased
#1
IV iron
increase
mean Hb
cancer patients with anemia
from 7.6 g/dL at baseline to 9.3 g/dL by day 60
increased
#2
IV iron
decrease
mean units of packed cells transfused per patient
cancer patients with anemia
by 55% within to 12 weeks
declined
#3
IV iron
increase
Hb
patients receiving supportive care alone
from 7.3 g/dL to 8.3 g/dL on day 28
rose
#4
IV iron
decrease
transfusions
patients receiving supportive care alone
62%
reduction
#5
IV iron
no change
adverse reactions
patients
in 4 patients (1.1%)
observed
#6
IV iron
increase
anemia
cancer patients with anemia
-
significantly improved
#7
IV iron
decrease
transfusion requirements
cancer patients with anemia
-
reduced
#8
Abstract

Background: Anemia is common in cancer patients receiving palliative care, causing significant symptom burden and transfusion requirement. While intravenous (IV) iron is recognized for its role in chemotherapy-induced anemia, its efficacy in broader palliative oncology settings is underexplored. Our study provides real-world experience with IV iron in cancer patients, particularly those receiving supportive care alone. Methods: This retrospective study was conducted at an integrated oncology center in Hong Kong from January 2019 to August 2023. Patients who received IV iron were evaluated for changes in hemoglobin (Hb) and transfusion requirements. Results: Among 283 eligible episodes, mean Hb increased from 7.6 g/dL at baseline to 8.8 g/dL and 9.3 g/dL by days 28 and 60, respectively (ps < 0.001). Mean units of packed cells transfused per patient declined by 55% within to 12 weeks following IV iron (P = 0.01). Among 164 (58%) patients receiving supportive care alone, Hb rose from 7.3 g/dL to 8.3 g/dL on day 28 (P < 0.001), with a 62% reduction in transfusions (P = 0.04). Adverse reactions were observed in 4 patients (1.1%), none with significant consequences. Baseline Hb, treatment intent and iron deficiency group significantly predicted Hb change on day 28 in multiple linear regression. Conclusion: IV iron significantly improved anemia and reduced transfusion requirements in cancer patients with anemia, including those receiving supportive care. To our knowledge, this study presents the largest dataset on IV iron use in cancer patients receiving supportive care to date. Future studies should explore its effect on symptoms management, quality of life and health-economic benefits.

Study Links
Quality Scores
Safety95
Efficacy85/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score1.25
Normalized Score0.87
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