Abstract
Anaemia is highly prevalent in cancer patients, adversely affects quality of life and impacts survival. The pathogenesis is multifactorial, with iron deficiency being a major and potentially treatable contributor. This study aimed to assess the effectiveness and economic impact of ferric carboxymaltose in chemotherapy-induced anaemia. This prospective cohort study between 2015–2016 of chemotherapy-treated patients for solid tumours, grade ≥2 anaemia and iron deficiency evaluated hematopoietic response four weeks after ferric carboxymaltose treatment. Transfusion rate of all cancer patients treated at our ambulatory unit during the two-year study period (2015–2016) was compared to a retrospective cohort (2013–2014) who received blood transfusion only. Between 2015–2016, 99 patients were included and treated with ferric carboxymaltose, the majority of whom (n = 81) had relative iron deficiency. Mean haemoglobin concentrations improved from 9.2 [6.7–10.8] g/dL to 10.6 [7.8–14.2] g/dL four weeks after treatment. A 26% reduction in the transfusion rate was observed from control retrospective to the prospective study group including ferric carboxymaltose treated patients [relative risk 0.74 (95% CI:0.66–0.83)]. The cost analysis showed a benefit for the use of ferric carboxymaltose in chemotherapy-induced anaemia. This study shows that ferric carboxymaltose is an effective, cost-saving support treatment, reducing the need for allogeneic transfusions saving blood units which are a limited resource.
Highlights
Anaemia is highly prevalent in cancer patients, adversely affects quality of life and impacts survival
Between 2015 and 2016, 99 patients with at least grade 2 anaemia (Hb < 10 g/dl) and iron deficiency[8] were included in the study and treated with ferric carboxymaltose (FCM) infusions according to body weight as described in the methods section
IV iron supplementation is widely used for the treatment of chronic iron deficiency anaemia
Summary
Anaemia is highly prevalent in cancer patients, adversely affects quality of life and impacts survival. Anaemia has a negative impact on the quality of life of cancer patients It is associated with poor performance status, fatigue, and may jeopardize adherence to treatment, affecting therapeutic results, hospital stay and even survival[4,5,6]. Anaemia may be attributed to absolute ID that can result from chronic blood loss due to gastrointestinal and gynaecological malignancies or surgery Less frequent, it can www.nature.com/scientificreports derive from nutritional deficiencies due to cancer-induced anorexia, as well as reduced iron absorption due to gastrectomy, or the use of proton pump inhibitors, taken approximately by 20% of cancer patients[11,12]. European Society for Medical Oncology (ESMO) guidelines considers functional ID when TSAT is
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