title: Intravenous iron supplementation for the treatment of chemotherapy-induced anaemia - systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Current guidelines are inconclusive regarding intravenous (IV) iron for treatment of chemotherapy-induced anaemia (CIA).
  
  
  METHODS
  Systematic review and meta-analysis of randomised controlled trials comparing IV iron with no iron or oral iron for treatment of chemotherapy induced anaemia (CIA).
  
  
  METHODS
  haematopoietic response and red blood cell (RBC) transfusion requirements. For dichotomous data, relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. For continuous data, weighted mean differences were calculated.
  
  
  RESULTS
  Eleven trials included 1681 patients, the majority examining the addition of IV iron to erythropoiesis stimulating agents (ESA) (1562 patients, 92.9%). IV iron significantly increased haematopoietic response rate [RR 1.28 (95% CI 1.125-1.45), seven trials with ESA] and decreased the rate of blood transfusions both in trials with ESA [RR 0.76 (95% CI 0.61-0.95), seven trials] and without ESA [RR 0.52 (95% CI 0.34-0.80)]. The increase in haematopoietic response rate correlated with total IV iron dose, regardless of baseline iron status. Mortality and safety profile was comparable between groups.
  
  
  CONCLUSIONS
  IV iron added to ESA results in an increase in haematopoietic response and reduction in the need for RBC transfusions, with no difference in mortality or adverse events.
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tiqwa, Israel. gn44@bezeqint. net
authors.forename: Anat
authors.initials: A
authors.lastname: Gafter-Gvili
authors.forename: Benaya
authors.initials: B
authors.lastname: Rozen-Zvi
authors.forename: Liat
authors.initials: L
authors.lastname: Vidal
authors.forename: Leonard
authors.initials: L
authors.lastname: Leibovici
authors.forename: Johan
authors.initials: J
authors.lastname: Vansteenkiste
authors.forename: Uzi
authors.initials: U
authors.lastname: Gafter
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001803:Blood Transfusion; D004359:Drug Therapy, Combination; D006397:Hematinics / Q000627:therapeutic use*; D006410:Hematopoiesis; D006801:Humans; D007262:Infusions, Intravenous; D058085:Iron Compounds / Q000627:therapeutic use*; D009369:Neoplasms / Q000188:drug therapy; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D058085:Iron Compounds