scholarly journals Evaluation of the Impact of Iron Deficiency Anemia during Pregnancy on Hospital Admission and Utilization of Hospital Resources in Latifa Women and Children Hospital, Dubai, UAE

2021 ◽  
pp. 1-6
Author(s):  
Nighat Aftab ◽  
Saima Faraz ◽  
Komal Hazari ◽  
Asma Fahad ◽  
Nadia AlSawalhee ◽  
...  
Keyword(s):  
Side Effects ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Pregnant Females ◽  
Oral Group ◽  
Iv Iron ◽  
Women And Children ◽  
The Cost ◽  
Cost Effect

<b><i>Introduction:</i></b> Iron deficiency anemia (IDA) is endemic among pregnant females worldwide. Liposomal iron preparation is a novel therapy for treating IDA in pregnant females. There is a lack of research on cost-effect and comparison between various new iron preparations as liposomal and intravenous (IV) iron supplements in the international literature. <b><i>Objective:</i></b> The objective of this study was to evaluate the cost-effect and maternal-fetal outcome of IDA during pregnancy in Latifa Women and Children Hospital, Dubai, UAE. <b><i>Design:</i></b> The study was a quasi-experimental study. <b><i>Settings:</i></b> Settings include tertiary-care hospital settings affiliated with academic center in UAE. <b><i>Patients and Methods:</i></b> A total of 226 pregnant women were inducted in the study who were controlled in terms of age, BMI, baseline hemoglobin (Hb), severity of anemia, and ferritin levels. There were 116 patients who received oral liposomal iron pyrophosphate and 110 patients received IV iron saccharate complex for 4 weeks. The overall cost-effect and maternal-fetal outcomes were compared in 2 groups. <b><i>Main Outcomes Measured:</i></b> The main outcomes measured the cost-effect of liposomal and IV iron therapy, and the 2 treatments were compared in terms of maternal and fetal outcomes. <b><i>Result:</i></b> The subjects were matched for age and body mass index and showed that the patients in the IV group were more symptomatic than those in the oral group (18.1 vs. 31.9% <i>p</i> value &#x3c;0.01). There was no statistically significant difference among women from different nationalities living in UAE (<i>p</i> value 0.079). There were 98 (84.4%) patients in the oral group and 99 (90%) patients in the IV group who achieved the desired Hb levels after 1 month of treatment (<i>p</i> value = 0.878). Moreover, the side effects were also comparable in both groups (1.72 vs. 1.82% <i>p</i> value = 0.56). The incremental cost-effect ratio for IV iron was USD 108,633/rise to desired Hb. <b><i>Conclusion:</i></b> Liposomal iron preparations may be cost-effective and have fewer side effects than IV iron. In terms of outcome, the maternal and fetal variables are comparable in liposomal and IV groups.

scholarly journals IRON DEFICIENCY ANEMIA

2016 ◽  
Vol 23 (06) ◽  
pp. 673-679
Author(s):  
Malahat Mansoor ◽  
Hammad Raza
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Blood Transfusions ◽  
Allergic Reactions ◽  
Food Fortification ◽  
Mild Anemia ◽  
Low Birth Weight Babies ◽  
Iv Iron ◽  
The Cost

Around 65% of pregnant women in South Asia suffer from IDA & in Indiansub-continent alone, the rate of developing IDA during pregnancy is 88%. Moreover anemicpregnant patients are more likely to give birth to low birth weight babies which itself is anotherfactor adding to socio-economic burden on the whole family. The food has not been fortified forIron, Zinc & Vitamin D & hence the prevention of anemia has not yet been achieved Objectives:To study Awareness of women about food fortification & prevention of IDA Vs cost for treatinganemia. Period: August 2015-Dec 2015. Study Design: Observational Study. Settings: At BhattiInternational Hospital, Kasur Results: Among the selected anemic women, almost half (55%)had mild anemia, while rest had moderate to severe anemia indicting that the prevalence is verycommon. The treatment offered was oral &/or IV Iron with blood transfusions. The cost of iv Irontherapy & blood transfusions estimates in thousands with added risks of Transfusion Reactions,allergic reactions& transmission of blood-borne diseases like HCV,HBV,HIV(AIDS)&others. Theawareness level was found to be poor among these women .Only 8/60 i.e 13% had someidea about iron deficiency anemia & almost none knew about food fortifications. The insightabout their own disease of IDA was also 35% (21/60) indicating that most of the women incommunity live with IDA without any understanding of a preventable condition. Conclusion:The cost & time spend to treat IDA can be minimizes creating awareness about food fortification& supplementation.

Treatment of Iron-Deficiency Anemia with IV Ferumoxytol in CKD Patients: Efficacy Compared with Oral Iron across Different Age Groups.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2679-2679 ◽  
Author(s):  
Louis Brenner ◽  
Paul Miller ◽  
Sally Rodriguez ◽  
Nainesh Parikh ◽  
Daniel W. Coyne
Keyword(s):  
Side Effects ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Age Groups ◽  
The Elderly ◽  
Oral Iron ◽  
Phase Iii ◽  
Deficiency Anemia ◽  
Iv Iron ◽  
Iron Replacement

Abstract Iron deficiency anemia is common in the elderly. It is an important medical issue particularly in patients with chronic kidney disease (CKD) because of the associated complications, including increased mortality, loss of functional independence, and cognitive and cardiovascular abnormalities. Oral iron replacement is frequently ineffective, being poorly tolerated due to GI side effects. Ferumoxytol, a novel semi-synthetic carbohydrate-coated iron oxide nanoparticle, is being developed as an IV iron therapy to treat iron deficiency anemia in adults and elderly CKD patients. Ferumoxytol is isotonic with plasma, has lower free iron than other available IV products, and can be given as a 510 mg dose via rapid IV bolus. To evaluate the safety and efficacy of iron replacement with ferumoxytol relative to oral iron in adults and elderly subjects with CKD, data were pooled from three open-label, multicenter, randomized Phase III trials (ClinicalTrials.gov identifiers NCT00255437, NCT00255424, and NCT00233597). In a modified ITT Population (subjects randomized and dosed), a total of 884 subjects with CKD stages 1–5 and 5D received either 2 doses of 510 mg of IV ferumoxytol within 5±3 days or 200 mg of elemental oral iron daily for 21 days (Ferro-Sequels®). The mean change from baseline to Day 35 for hemoglobin (Hgb, the primary endpoint in these Phase III studies) was analyzed using an ANOVA with fixed effects for treatment and age categories (&lt;50, 50 to &lt;65, 65 to &lt;75, and ≥75 years) and their interaction. There was a highly significantly greater Hgb response with IV ferumoxytol relative to oral iron across all age groups (mean ± SD were 1.03±1.22 g/dL for ferumoxytol vs. 0.42±1.05 g/dL for oral iron, p&lt;0.0001). The Hgb response to IV ferumoxytol was consistently observed regardless of age and was greater than the response seen with oral iron (see Table for mean ± SD values). By contrast, there appeared to be a diminished response to oral iron with increasing age. Subject incidences of adverse events with ferumoxytol were similar to or lower than those observed with oral iron in all 3 studies. Multiple factors, including patient compliance, concomitant medications, and impaired GI absorption and/or side effects, may contribute to the ineffectiveness of oral iron. Therefore, physicians should consider the use of IV iron to more effectively treat iron deficiency anemia in all adult CKD patients, including the elderly. Change in Hemoglobin at Day 35 Ferumoxytol 2×510 mg Oral Iron Age N Baseline Hgb Change in Hgb at Day 35 N Baseline Hgb Change in Hgb at Day 35 Relative Change in Hgb (Ferumoxytol vs Oral Iron) All 605 10.15 ± 0.81 1.03 ± 1.22 279 10.33 ± 0.78 0.42 ± 1.05 245% &lt;50 105 10.22 ± 0.96 1.06 ± 1.38 38 10.16 ± 0.96 0.58 ± 1.42 183% 50 to &lt;65 192 10.14 ± 0.80 1.00 ± 1.13 112 10.40 ± 0.79 0.43 ± 1.07 233% 65 to &lt;75 163 10.14 ± 0.76 0.92± 1.19 70 10.33 ± 0.75 0.46 ± 0.89 200% ≥75 145 10.10 ± 0.74 1.17 ± 1.27 59 10.28 ± 0.69 0.25 ± 0.89 468%

scholarly journals Multidisciplinary Implementation of an Iron Deficiency Anemia in Pregnancy Treatment Protocol

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2121-2121
Author(s):  
Pooja Mehra ◽  
Surabhi Palkimas ◽  
Laura Parsons ◽  
Theresa Libby ◽  
Leslie Ward ◽  
...  
Keyword(s):  
Side Effects ◽  
Iron Deficiency ◽  
Blood Transfusion ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Third Trimester ◽  
Iv Iron ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Background: Anemia in pregnancy increases the need for blood transfusion during and after delivery and is associated with an increased risk of maternal and fetal mortality, therefore preventing maternal anemia may improve outcomes. Iron deficiency is the most common pathologic cause of anemia in pregnancy and is estimated to affect about 30% of pregnant women in the third trimester in the US. The baseline peripartum blood transfusion rate at our institution is 3.2%. Historically, patients who may have benefited from intravenous (IV) iron were continued on oral iron and subsequently delivered with persistent iron deficiency anemia. If identified to need IV iron, these patients were usually referred to a hematologist. However, in the absence of a structured protocol, referral was provider-dependent. Objective: We formed a multidisciplinary work group consisting of members from the departments of Hematology, Obstetrics, Pharmacy, Nursing, and Blood Bank to reduce peripartum blood transfusions by developing a process to manage pregnant patients with iron deficiency anemia. The treatment algorithm utilized at our institution was adapted from "How I treat anemia in pregnancy: iron, cobalamin, and folate" (Achebe & Gafter-Gvili, 2017), which recommends IV iron for hemoglobin less than 11 g/dL and ferritin less than 30 µg/dL in the third trimester and for hemoglobin less than 10.5 g/dL and ferritin less than 30 µg/dL in the second trimester along with recommendations for iron repletion in the first trimester. The primary endpoint was the utilization of blood transfusion. Secondary endpoints included an increase in maternal hemoglobin after treatment and evaluating the safety of IV ferric carboxymaltose as measured by side effects and frequency of hypophosphatemia. Five months after initiation of the IV iron recommendations, we performed an audit to assess its use. Methods: A retrospective IRB-approved chart review of anemic, iron-deficient pregnant women who received IV ferric carboxymaltose from 1/30/19 - 6/30/19 was performed. Thirty-six patients were identified and their charts were reviewed to determine the hemoglobin and ferritin levels prior to IV iron, the number of IV iron infusions received with any side effects, phosphorus levels on days of IV iron, hemoglobin level after IV iron, and need for peripartum blood transfusion. Results: Of the 36 patients who received IV iron for anemia in pregnancy, post-IV iron hemoglobin and blood transfusion information was only available for 26 patients. The remaining 10 patients had not delivered as yet or had delivered at another institution so data were not available. Of these 26 patients, the median age was 26.0 years and all received IV iron during their third trimester. No patients required a blood transfusion peripartum. The average hemoglobin prior to IV iron was 9.3 g/dL and the average hemoglobin after 1-2 IV iron infusions was 11.3 g/dL, an increase of 2.0 g/dL across the total group (Figure 1) (p<0.0001). Of these 26 patients, 7 patients received 1 dose of IV iron and 2 patients experienced heartburn or nausea during or soon after the IV iron infusion. Phosphorus levels were checked in 24 patients and 6 experienced hypophosphatemia with no attributable side effects. No patient experienced a serious adverse effect or reaction requiring discontinuation of IV iron therapy. Conclusion: Results from the first 5 months of this project suggest using a standardized iron deficiency anemia treatment protocol including IV iron to reduce the need for peripartum blood transfusion and increase hemoglobin levels. Additionally, our data suggest IV ferric carboxymaltose is well-tolerated in these patients. These results also support using multi-professional teams to improve the quality of healthcare delivery to pregnant patients with iron deficiency anemia. We have created an IRB-approved database to study more patient-centered postpartum outcomes such as quality of life among IV iron recipients as well as lactation rates and fetal outcomes. We plan to expand this strategy to other patients who have a predictable and likely preventable need for intermittent blood transfusion, such as patients with chronic gynecologic blood loss. Reference: Achebe, M. M., & Gafter-Gvili, A. (2017). How I treat anemia in pregnancy: iron, cobalamin, and folate. Blood, 129(8), 940-949. https://doi.org/10.1182/blood-2016-08-672246. Disclosures Davidson: ABIM: Other: American Board of Internal Medicine.

scholarly journals Lactoferrin Efficacy versus Ferrous Sulfate in Treatment of Children with Iron Deficiency Anemia

2021 ◽  
Vol 11 (01) ◽  
pp. e199-e204
Author(s):  
Osama Mahmoud El-Asheer ◽  
Ahmed Gaber Ahmed ◽  
Zainab AbdelAal Abdel Hafez ◽  
Marwa AbdelHafiz Dahpy ◽  
Amal AbdElSalam Soliman
Keyword(s):  
Side Effects ◽  
Iron Deficiency ◽  
Patient Compliance ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Serum Iron ◽  
Deficiency Anemia ◽  
Serum Transferrin ◽  
Iron Binding ◽  
Clinical Benefits

AbstractLactoferrin (LF) is an iron-binding globular glycoprotein that is structurally and chemically similar to serum transferrin. Many studies have been done to evaluate the effect of oral LF administration on iron deficiency anemia (IDA) with controversial results. This study was designed to compare the efficacy of LF versus oral ferrous sulfate (OFS) therapy in the treatment of children with IDA. A significant increase in mean hemoglobin and serum iron concentrations was noted in the group that received oral bovine LF (11.06 ± 0.96 and 42.79 ± 6.14, respectively) versus the group that received OFS (10.24 ± 0.57 and 28.94 ± 5.05, respectively, with p < 0.001 for each) after 30 days of the treatment with fewer side effects (9.3 vs. 33.3% with p = 0.043). Oral bovine LF is a more effective and safer alternative in treating iron deficiency and IDA compared with OFS with clinical benefits of fewer side effects and better patient compliance.

Intravenous versus Oral iron for Iron-Deficiency Anemia in Pregnancy (IVIDA): A Randomized Controlled Trial

2021 ◽  
Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Randomized Controlled ◽  
Iv Iron ◽  
Severe Adverse Reactions

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points

Iron Amino Acid Chelates

2004 ◽  
Vol 74 (6) ◽  
pp. 435-443 ◽  
Author(s):  
Hertrampf ◽  
Olivares
Keyword(s):  
Amino Acid ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Iron Absorption ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Efficacy Trials ◽  
Food Matrices ◽  
The Cost

Iron amino acid chelates, such as iron glycinate chelates, have been developed to be used as food fortificants and therapeutic agents in the prevention and treatment of iron deficiency anemia. Ferrous bis-glycine chelate (FeBC), ferric tris-glycine chelate, ferric glycinate, and ferrous bis-glycinate hydrochloride are available commercially. FeBC is the most studied and used form. Iron absorption from FeBC is affected by enhancers and inhibitors of iron absorption, but to a lesser extent than ferrous sulfate. Its absorption is regulated by iron stores. FeBC is better absorbed from milk, wheat, whole maize flour, and precooked corn flour than is ferrous sulfate. Supplementation trials have demonstrated that FeBC is efficacious in treating iron deficiency anemia. Consumption of FeBC-fortified liquid milk, dairy products, wheat rolls, and multi-nutrient beverages is associated with an improvement of iron status. The main limitations to the widespread use of FeBC in national fortification programs are the cost and the potential for promoting organoleptic changes in some food matrices. Additional research is required to establish the bioavailability of FeBC in different food matrices. Other amino acid chelates should also be evaluated. Finally there is an urgent need for more rigorous efficacy trials designed to define the relative merits of amino acid chelates when compared with bioavailable iron salts such as ferrous sulfate and ferrous fumarate and to determine appropriate fortification levels

scholarly journals Management of postpartum iron deficiency anemia: review of literature

2018 ◽  
Vol 8 (1) ◽  
pp. 338
Author(s):  
Mohamed Saber ◽  
Mohamed Khalaf ◽  
Ahmed M. Abbas ◽  
Sayed A. Abdullah
Keyword(s):  
Iron Deficiency ◽  
Blood Transfusion ◽  
Iron Deficiency Anemia ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Allogenic Blood Transfusion ◽  
Iron Dextran ◽  
Peripheral Tissues ◽  
Iv Iron

Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis.

Treatment of Iron Deficiency Anemia in Pregnancy with Intravenous versus Oral Iron: Systematic Review and Meta-Analysis

2018 ◽  
Vol 36 (04) ◽  
pp. 366-376 ◽  
Author(s):  
Richard Burwick ◽  
Shravya Govindappagari
Keyword(s):  
Systematic Review ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Meta Analysis ◽  
Oral Iron ◽  
Sensitivity Analyses ◽  
Deficiency Anemia ◽  
Iv Iron ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Objective To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the benefits of intravenous (IV) iron in pregnancy. Study Design Systematic review was registered with PROSPERO and performed using PRISMA guidelines. PubMed, MEDLINE, Web of Science, ClinicalTrials.gov, Cochrane Library, and Google Scholar were searched. Eleven RCTs, comparing IV to oral iron for treatment of iron-deficiency anemia in pregnancy, were included. Meta-analyses were performed with Stata software (College Station, TX), utilizing random effects model and method of DerSimonian and Laird. Outcomes were assessed by pooled odds ratios (OR) or pooled weighted mean difference (WMD). Sensitivity analyses were performed for heterogeneity. Results We found that pregnant women receiving IV iron, compared with oral iron, had the following benefits: (1) Achieved target hemoglobin more often, pooled OR 2.66 (95% confidence interval [CI]: 1.71–4.15), p < 0.001; (2) Increased hemoglobin level after 4 weeks, pooled WMD 0.84 g/dL (95% CI: 0.59–1.09), p < 0.001; (3) Decreased adverse reactions, pooled OR 0.35 (95% CI: 0.18–0.67), p = 0.001. Results were unchanged following sensitivity analyses. Conclusion In this meta-analysis, IV iron is superior to oral iron for treatment of iron-deficiency anemia in pregnancy. Women receiving IV iron more often achieve desired hemoglobin targets, faster and with fewer side effects.

Iron Deficiency Anemia in Cancer Patients

2012 ◽  
Vol 08 (02) ◽  
pp. 74
Author(s):  
Mark Janis ◽  
Keyword(s):  
Iron Deficiency ◽  
Cancer Patients ◽  
Iron Deficiency Anemia ◽  
Iron Transport ◽  
The Body ◽  
Deficiency Anemia ◽  
Functional Iron Deficiency ◽  
Iron Stores ◽  
Iv Iron ◽  
Absolute Iron Deficiency

Anemia is highly prevalent, affecting approximately 40 % of cancer patients, and results in a significant decrease in health-related quality of life while also being associated with shorter cancer survival times. A recent survey of 15,000 cancer patients in Europe found that 39 % were anemic at the time of enrolment. In addition, anemia is a recognized complication of myelosuppressive chemotherapy, and it has been estimated that, in the US, around 1.3 million cancer patients who are not anemic at the time of diagnosis will develop anemia during the course of their disease. The etiology of anemia in cancer patients is variable and often multifactorial, and may be the result of an absolute or a functional iron deficiency. Cancer produces an enhanced inflammatory state within the body—causing hepcidin levels to increase and erythropoietin production to decrease—and results in a reduction in erythropoiesis due to impaired iron transport. This type of anemia is known as functional iron deficiency, where the body has adequate iron stores but there are problems with mobilization and transport of the iron. Absolute iron deficiency is when both iron stores and iron transport are low. The National Comprehensive Cancer Network (NCCN) treatment guidelines for cancer-related anemia recommend intravenous (IV) iron products alone for iron repletion in cancer patients with absolute iron deficiency, and erythropoiesis-stimulating agents (ESAs) in combination with IV iron in cancer patients (currently undergoing palliative chemotherapy) with functional iron deficiency. Although IV iron has been demonstrated to enhance the hematopoietic response to ESA therapy, the use of supplemental iron has not yet been optimized in oncology. Here we discuss the significance of iron deficiency anemia in cancer patients and the need to implement tools to properly diagnose this condition, and we provide an overview of the management strategies and recommendations for patients with iron deficiency anemia as outlined in the NCCN guidelines.

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