Haematology

A recent study by Munoz and colleagues demonstrated that transfusion rates in patients with hip fracture were lower in those who received intravenous iron compared with those who received no iron therapy (32.4 vs 48.8%, respectively; n=2547). Postoperative nosocomial infection rates were lower in patients who received intravenous iron, as was thirty-day mortality and length of hospital stay1.

Intravenous iron may improve erythroid recovery in patients treated with DA after haematopoietic cell transplantation (HCT). Darbepoetin alfa (DA) helps to ensure full erythroid reconstitution after autologous HCT when started on day 28 post-transplant, a new study indicates.

Bacteria require iron for normal metabolism. This fact has led to conjecture that iron therapy is responsible for an increase in observed infections. To date, there is no prospective data to support that contention, while several prospective and observational studies suggest the opposite. Iron is a pro-oxidant and an important nutrient for many bacteria. In the laboratory, the addition of iron to animals exacerbates sepsis.

The wide range of iron deficiency aetiologies from across the therapeutic spectrum as well as the most up-to-date advances in treatment, are highlighted in a comprehensive review by expert in the field and Iron Therapy Editorial Board member, Professor Michael Auerbach. The authors describe the far-reaching impact of iron deficiency on patients’ well-being and clinical outcomes, and further present intravenous iron therapy as an effective treatment alternative to oral iron.

Most physicians and health managers assume that allogeneic blood transfusion (ABT) is always life-saving, cheap, free of risk, and cost–effective. This is believed despite questionable efficacy and increasingly reported adverse events in patients who undergo ABT. In contrast, alternatives to allogeneic blood transfusion (AABT) are frequently considered less efficacious and non cost–effective when compared with conventional ABT.

Intravenous ferric carboxymaltose is a suitable alternative to iron dextran for patients with iron deficiency anaemia, new data indicate. Ferric carboxymaltose showed similar efficacy (including change in haemoglogin) compared with iron dextran, with fewer allergic reactions and a greater effect on the restoration of iron (ferritin) stores.

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