Iron and the anaemia of chronic disease: a review and strategic recommendations

Cavill, I.; Auerbach, Michael; Bailie, George R.; Barrett-Lee, Peter; Béguin, Yves; Kaltwasser, Peter; Littlewood, Tim; Macdougall, Iain C.; Wilson, Keith A.

doi:10.1185/030079906x100096

Cited by 75 publications

(55 citation statements)

References 46 publications

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“…6,8,9 Intestinal iron absorption is often reduced in malignant disease 7 and oral iron treatment is associated with poor patient compliance. In contrast, intravenous iron supplementation improves response to epoetin and decreases epoetin dose requirements in patients with chronic kidney disease (CKD) and anemia.…”

Section: Introductionmentioning

confidence: 99%

Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study

et al. 2007

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This randomized study assessed if intravenous iron improves hemoglobin (Hb) response and permits decreased epoetin dose in anemic (Hb 9-11 g/dl), transfusion-independent patients with stainable iron in the bone marrow and lymphoproliferative malignancies not receiving chemotherapy. Patients (n ¼ 67) were randomized to subcutaneous epoetin beta 30 000 IU once weekly for 16 weeks with or without concomitant intravenous iron supplementation. There was a significantly (Po0.05) greater increase in mean Hb from week 8 onwards in the iron group and the percentage of patients with Hb increase X2 g/dl was significantly higher in the iron group (93%) than in the noiron group (53%) (per-protocol population; P ¼ 0.001). Higher serum ferritin and transferrin saturation in the iron group indicated that iron availability accounted for the Hb response difference. The mean weekly patient epoetin dose was significantly lower after 13 weeks of therapy (P ¼ 0.029) and after 15 weeks approximately 10 000 IU (425%) lower in the iron group, as was the total epoetin dose (P ¼ 0.051). In conclusion, the Hb increase and response rate were significantly greater with the addition of intravenous iron to epoetin treatment in iron-replete patients and a lower dose of epoetin was required.

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Section: Introductionmentioning

confidence: 99%

Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study

et al. 2007

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“…Finally, the content of the Dutch guidelines used for handling newly diagnosed patients with ACD is also widely accepted in other guidelines worldwide. 2,20,23 …”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…2,[14][15][16] In this study, severe anaemia and minimally reduced ferritin levels (i.e. <324 mg/l) are associated with increased oral iron prescription by GPs.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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Diagnostics in anaemia of chronic disease in general practice: a real-world retrospective cohort study

Schop

Stouten

Houten³

et al. 2018

BJGP Open

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“…Free-iron may also exacerbate certain infections, as iron is essential for intracellular bacteria to grow and survive in the cell (Collins, 2003). Furthermore, free-iron induces the generation of free radicals that increase oxidative stress, potentially leading to atherosclerosis and cardiotoxicity, especially in cancer patients receiving cardiotoxic chemotherapeutic drugs (Sengölge et al, 2005;Cavill et al, 2006). The idea that iron is safe is still a hidden assumption (Sullivan, 2004(Sullivan, , 2007.…”

Section: Review ª 2008 the Authorsmentioning

confidence: 99%

Use of erythropoiesis stimulating agents and intravenous iron for cancer and treatment‐related anaemia: the need for predictors and indicators of effectiveness has not abated

Katodritou¹,

Zervas²,

Terpos³

et al. 2008

Br J Haematol

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SummaryCancer and treatment‐related anaemia is a significant clinical problem. Erythropoiesis stimulating agents (ESA) improve anaemia and ultimately enhance patients’ quality of life. However, about one‐third of patients do not respond to ESA administration, mostly because of the impaired supply of iron to the erythroid marrow (functional iron deficiency). Concomitant administration of intravenous (IV) iron may improve responsiveness. The use of baseline predictors of response to ESA and of indicators of appropriateness of response and iron availability should allow targeted therapeutic interventions with both ESA and IV iron. Several biochemical and haematological indicators of response and of iron balance have been studied, but firm criteria for their use have not yet been rigorously established. The commonly used early predictive markers of response to ESA, such as baseline endogenous erythropoietin levels and an increase in haemoglobin, reticulocytes, and soluble transferrin receptor levels during ESA treatment, have not proved reliable due to their low sensitivity and specificity. Traditional markers of iron availability, such as serum ferritin and transferrin saturation display interpretation pitfalls. The need for predictors and indicators of responsiveness to ESA and IV iron is still current and clinically relevant.

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Iron and the anaemia of chronic disease: a review and strategic recommendations

Cited by 75 publications

References 46 publications

Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study

Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study

Diagnostics in anaemia of chronic disease in general practice: a real-world retrospective cohort study

Use of erythropoiesis stimulating agents and intravenous iron for cancer and treatment‐related anaemia: the need for predictors and indicators of effectiveness has not abated

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