Oncology

Hepcidin may differentiate between types of anaemia, which may lead to varied therapeutic strategies, according to new research. Authors suggest that hepcidin may be more effective as a diagnostic marker of anaemia in cancer patients than serum iron, total iron-binding capacity (TIBC), or transferrin saturation (TSAT). They state that hepcidin could be used as a serological marker in the differential diagnosis of tumour-related anaemia of chronic disease (ACD) and iron deficiency anaemia.

Keeler and colleagues recently provided further evidence to support the use of intravenous iron to treat the anaemia associated with colorectal adenocarcinoma. This small open-label study was in the pre-operative setting, where previous studies have demonstrated that untreated anaemia can contribute to adverse postoperative outcomes.

Iron deficiency can have a significant, deleterious effect on quality of life in patients with specific types of cancer. Evidence suggests a correlation between iron deficiency and poor Eastern Cooperative Oncology Group (ECOG) performance status in patients with solid tumours; however no such correlation is observed in patients with haematological malignancies1.

Iron deficiency also correlates with significant impairment of physical, immunological and cognitive function, and fatigue, in patients with non-malignant tumours1,2.

A new study suggests that iron therapy can be given to iron-deficient rats undergoing anthracycline-based chemotherapy without increasing anthracycline-induced cardiotoxicity (AIC). The authors suggest that oxidative and nitrosative stress, inflammation, and cardiotoxicity, may be reduced by iron therapy treatment in this animal group.

A survey in patients treated for chemotherapy-induced anaemia (CIA) indicates that management of anaemia and assessment of iron status varies substantially across Europe and that iron therapy is frequently under-utilised.

Patients with cancer frequently experience CIA and iron deficiency. This study evaluated routine practice in CIA management. Medical oncologists and haematologists from nine European countries (n=375) were surveyed on their last five cancer patients treated for CIA (n=1,730).

Iron deficiency is a frequent complication associated with cancer. In a single-centre study of 1528 patients presenting sequentially between 1 October 2009 and 20 January 2010, more than 40% had iron deficiency, defined as a transferrin saturation (TSAT) level of <20% (see figure below)1.

Patients with colon cancer are more likely to experience comorbidities if they also present with iron deficiency anaemia, a new study indicates. Researchers suggest that inferior survival outcomes could be due to a higher prevalence of diabetes, cardiovascular disease, and chronic kidney disease.

Both iron deficiency and iron overload correlate with organ impairment in patients with multiple myeloma, but iron deficiency is observed more frequently according to recent findings, study authors report.

Approximately 97% of patients with multiple myeloma develop anaemia during the course of their disease. Usually, anaemia in these patients is normocytic/normochromic, combined with normal to low iron levels and elevated ferritin levels.

20Jeong et al recently reported the results of a retrospective observational study of 527 patients undergoing gastrectomy for gastric carcinoma. Patients with acute postoperative anaemia (haemoglobin <10 g/dL) received intravenous iron sucrose. Patients with preexisting, preoperative anaemia were excluded. A dose of 300 mg was administered every other day until reaching the total target amount, calculated as:

(body weight x [target haemoglobin – current haemoglobin] x 0.24) + 500 mg

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