title: Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron.
abstract: BACKGROUND
  Chronic diseases reduce the availability of iron for effective erythropoiesis. This review summarises clinical consequences of iron deficiency (ID) and anaemia in cancer patients, mechanisms how impaired iron homeostasis affects diagnosis and treatment of ID, and data from clinical trials evaluating i.v. iron with or without concomitant erythropoiesis-stimulating agents (ESAs).
  
  
  METHODS
  Clinical trial reports were identified in PubMed and abstracts at relevant major congresses.
  
  
  RESULTS
  Reported prevalence of ID in cancer patients ranges from 32 to 60% and most iron-deficient patients are also anaemic. Randomised clinical trials have shown superior efficacy of i.v. iron over oral or no iron in reducing blood transfusions, increasing haemoglobin, and improving quality of life in ESA-treated anaemic cancer patients. Furthermore, i.v. iron without additional ESA should be evaluated as potential treatment in patients with chemotherapy-induced anaemia. At recommended doses, i.v. iron is well tolerated, particularly compared with oral iron. No serious drug-related adverse effects were seen during long-term use in renal disease and no effect on tumour growth has been observed in trials with anaemic cancer patients.
  
  
  CONCLUSIONS
  Reliable diagnosis and treatment of ID are recommended key steps in modern cancer patient management to minimise impact on quality of life and performance status.
authors.affiliation: IMO Clinique de Genolier, Genolier, Switzerland. Electronic address: maapro@genolier.net.
authors.forename: M
authors.initials: M
authors.lastname: Aapro
authors.affiliation: Department of Hematology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Österborg
authors.affiliation: Department of Haematology-Oncology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Gascón
authors.affiliation: Department of Medicine I, Center for Oncology and Haematology, Wilhelminenspital, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Ludwig
authors.affiliation: Department of Medicine, Division of Hematology, University Hospital Liège, Liège, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Beguin
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D058085:Iron Compounds / Q000008:administration & dosage*; D009369:Neoplasms / Q000097:blood* / Q000150:complications*; D015995:Prevalence
chemical_list: D058085:Iron Compounds