Increased level of serum iron and gastrointestinal toxicity in patients with solid tumor treated with cytotoxic chemotherapy.

Abstract

e13049 Background: The mechanism of gastrointestinal toxicity of chemotherapy including nausea and vomiting especially in late phase remains unclear. Nausea and vomiting are also known as major side effects of iron supplementation in pregnancy or anemia patients. The relationship between serum iron level and toxicity of chemotherapy was investigated. Methods: A total of 17 patients with solid tumor treated with cytotoxic chemotherapy were examined. The blood samples were taken before and on day 2 or 3 of chemotherapy. The changes of serum iron, unsaturated iron capacity (UIBC) and ferritin were measured to analyze the relationship with adverse effect. Results: The number of patients received each chemotherapy were 5 for carboplatin /gemcitabine, 2 for calboplatin/etoposide, calboplatin/paclitaxel, and irinotecan, and 1 for cisplatin/etoposide, calboplatin/pemetrexed, amurubicin, docetaxel, gemcitabine and pemetrexed. Mean values of iron, UIBC and ferritin before and after chemotherapy were 60.5±18.0 vs. 220.5±17.0μg, 202.5±42.8 vs. 23.0±45.7μg, and 211.4±103.8 vs. 263.5±164.2 ng/ml, respectively. Statistically there were no significant correlation between iron level and adverse effects, however there were tendency that nausea and vomiting of grade 3 or 4 were observed more in patients with higher iron level. Conclusions: Regardless of various chemotherapy regimens, the iron levels on day 2 or 3 of chemotherapy were markedly increased in all patients. Correspondingly, UIBC were extremely decreased and reached to 0μg in 4 patients sufffering severe nausea and vomiting. These results imply that increased radial iron in serum is one of causes of gastrointestinal toxicity, which may be a target of minimizing complications of cancer chemotherapy.