Intravenous Iron Improves Treatment Response In Cancer Related Anemia
Main Category: Cancer / OncologyAlso Included In: Blood / Hematology; Conferences
Article Date: 16 Sep 2008 - 1:00 PDT
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For patients with chemotherapy-induced anemia, adding intravenous iron to treatment with the drug darbepoetin alfa results in a faster and more potent improvement in response with lower doses of the drug, according to data presented at the 33rd Congress of the European Society for Medical Oncology (ESMO) in Stockholm.
Anemia is a common problem in cancer patients, caused by a combination of factors including the malignancy itself, plus the effects of chemotherapy. Treatments can include drugs such as darbepoetin alfa, which stimulates the production of new blood cells, although up to one in three patients do not respond to these therapies.
Dr. Michael Auerbach, a hematologist from Baltimore, Maryland, USA, and colleagues studied whether adding intravenous iron would improve response rate in a group of 238 patients with a range of cancer types. The researchers divided the patients into four groups: either high-dose darbepoetin alfa plus or minus iron, or low-dose darbepoetin alfa plus or minus iron.
"In a large subset of patients with cancer-related anemia, an important factor that limits their response to treatment is the presence of an iron deficiency," Dr. Auerbach said.
The results of the 18-week trial showed that adding intravenous iron, administered every three weeks, improved the likelihood that patients achieved the target for hemoglobin levels, and reduced the length of time it took to see an improvement in the production of red blood cells, Dr. Auerbach reported. The results held true for either dose of darbepoetin alfa.
Other studies have shown that adding intravenous iron can have a similar impact with other erythropoiesis drugs, he noted. "This is the sixth of six studies to show it. They all decreased the need for erythropoiesis stimulating agents--for the same benefit with huge cost savings and probable decreased toxicity."
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15 Feb. 2012. <http://www.medicalnewstoday.com/releases/121525.php>
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Anemia May Be Adaptive To The Human Body
posted by Gregory D. Pawelski on 7 Oct 2008 at 2:17 pmSome cautionary information about anemia. A study, published in the Canadian Medial Association Journal, suggests patients with anemia due to chronic disease are being dangerously overtreated. Anemia may actually help heal the body rather than harm it, says the new study.
Dr. Ryan Zarychanski, the study's co-author and a scientist at the Ottawa Health Research Institute, feels that doctors have been taught for generations that anemia is bad and they want to help their patients by treating it. However, they failed to consider that anemia may be adaptive and may be exactly the response that the body needs at that time.
Tired blood (anemia) involves a shortage of healthy red blood cells to carry oxygen to the body tissues. In the past, blood transfusions were the only way to treat anemia, until a drug derived from erythropoietin (EPO), a hormone that stimulates bone-marrow cells to produce red-blood cells.
Dr. Zarychanski pointed to evidence that suggests anemia is an evolutionary response to illness occuring in humans. The body has adapted over thousands of years to be anemic at times of stress because it needs to conserve energy. It needs help to fight infection. And when you're anemic, bacteria doesn't grow so well in the blood (an evolutionary response to infection before antibiotics).
In general, healthy adults have red blood cell levels of 14 grams or more per 100 millilitres of blood, while patients are considered to need treatment if their levels are below 10 grams. Patients with mild to moderate anemia (those with levels between 10 and 14 grams) would be better off not being treated.
What Dr. Zarychanski argues is that we should exercise some caution when thinking the best treatment is to automatically transfuse or give drugs to correct anemia.
Source: Ottawa Health Research Institute
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