Single Dose Preoperative Administration of Intravenous Iron Corrects Iron Deficiency Anaemia in Colorectal Cancer

Abstract

Preoperative iron defi ciency anaemia (IDA) is common and associated with poor postoperative outcomes. Standard treatment includes allogenic blood transfusion or oral iron supplementation, but new intravenous iron strategies have shown promise in the perioperative setting. We aim to assess the feasibility and effect of a single dose of intravenous iron in treating preoperative colorectal cancer related anaemia.We performed an open labelled phase I uncontrolled trial. Patients with a diagnosis of colorectal cancer and biochemically proven IDA received intravenous iron a minimum of 14 days prior to surgery. Blood parameters including haemoglobin values were measured at pre-dose and preoperative time points.Eight of the ten patients responded to intravenous iron supplementation with a mean preoperative rise in haemoglobin of 1.1 g/dl (p=0.036). Ferritin levels rose by a mean of 523.4ng/ml across the ten patients. No adverse events occurred in any of the trial patients.This trial demonstrates that intravenous iron is both a feasible and effective treatment for IDA in anaemic colorectal cancer patients. However two patients did not respond to treatment, highlighting the need to identify biochemical markers which will accurately predict the underlying cause for anaemia and response to treatment.

Influence of Weather and Purity of Plasticizer on Degradation of Cassava Starch Bioplastics in Natural Environmental Conditions

“…Plastics of natural origin are referred to as 'Bioplastics'. These are abundant in nature and are either derived directly from biological systems or chemically synthesized from biological building blocks [12]. Starch is one of the major building blocks in bioplastic production.…”

“…Different bioplastics have been produced from starch which includes: Thermal plastic starch (TPS), starch blends with biodegradable polyesters like Polylactic acid (PLA) Polycaprolactone & Ecoflex among others with promising quality [10] [11]. Glycerol is generated as a byproduct in the biodiesel production whose direct disposal has negative environmental effects but once purified it has multiple applications in cosmetics, polymers, pharmaceutical [12] and food. Use of this glycerol as a plasticizer has environmental benefits of reduced pollution and production of an environment-friendly bioplastic.…”

Is Intravenous Iron Useful for Reducing Transfusions in Surgically Treated Colorectal Cancer Patients?

“…In the preoperative setting, a number of studies have been made in colorectal cancer patients with anemia secondary to iron deficiency in which the administration of intravenous iron alone did prove effective. Thus, Simpson et al [2] found that the administration of a single intravenous dose of iron significantly increased the hemoglobin levels, specifically by 1.1 g/dl ( P = 0.0359). In other studies [20, 21], intravenous iron (maximum 600 mg/week during 2–4 weeks) induced a significant increase in hemoglobin, with important correction of the anemia and a lessened need for allogeneic blood transfusion.…”

“…Anemia is one of the most frequent disorders in the elderly population (17–63 %), and it is particularly common in surgical patients [1]. In colon cancer patients, the type of anemia observed is fundamentally associated with ferropenia, although it is also common for these patients to have anemia of chronic diseases [2, 3].…”