title: Iron metabolism and iron supplementation in cancer patients.
abstract: Iron deficiency and iron deficiency-associated anemia are common complications in cancer patients. Most iron deficient cancer patients present with functional iron deficiency (FID), a status with adequate storage iron, but insufficient iron supply for erythroblasts and other iron dependent tissues. FID is the consequence of the cancer-associated cytokine release, while in absolute iron deficiency iron stores are depleted resulting in similar but often more severe symptoms of insufficient iron supply. Here we present a short review on the epidemiology, pathophysiology, diagnosis, clinical symptoms, and treatment of iron deficiency in cancer patients. Special emphasis is given to intravenous iron supplementation and on the benefits and limitations of different formulations. Based on these considerations and recommendations from current international guidelines we developed recommendations for clinical practice and classified the level of evidence and grade of recommendation according to the principles of evidence-based medicine.
authors.affiliation: c/o 1. Medizinische Abteilung, Zentrum für Onkologie, Wilhelminen-Krebsforschungsinstitut, Wilhelminenspital, Montleartstraße 37, 1160, Wien, Austria. heinz.ludwig@aon.at.
authors.forename: Heinz
authors.initials: H
authors.lastname: Ludwig
authors.affiliation: Universitätsklinik für Innere Medizin III, MedUni, Wien, Austria.
authors.forename: Rayko
authors.initials: R
authors.lastname: Evstatiev
authors.affiliation: Universitätsklinik für Innere Medizin I, MedUni, Wien, Austria.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Kornek
authors.affiliation: Institut Multidisciplinaire d'Oncologie IMO, Clinique de Genolier, Genolier, Switzerland.
authors.forename: Matti
authors.initials: M
authors.lastname: Aapro
authors.affiliation: Universitätsklinik für Innere Medizin, MedUni, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauernhofer
authors.affiliation: Abteilung Interne 1, KH der Elisabethinen, Linz, Austria.
authors.forename: Veronika
authors.initials: V
authors.lastname: Buxhofer-Ausch
authors.affiliation: Abteilung Interne 3, AKH, Linz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Fridrik
authors.affiliation: 1. Medizinische Abteilung, Klinikum Klagenfurt, Klagenfurt, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Geissler
authors.affiliation: 5. Medizinische Abteilung, Krankenhaus Hietzing, Wien, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Geissler
authors.affiliation: Universitätsklinik für Innere Medizin I, MedUni, Wien, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Gisslinger
authors.affiliation: 3. Medizinische Abteilung, Hanusch-Krankenhaus, Wien, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Koller
authors.affiliation: 1. Medizinische Abteilung, Landesklinikum St. Pölten, Pölten, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kopetzky
authors.affiliation: Abteilung für Innere Medizin, Landeskrankenhaus Feldkirch, Feldkirch, Austria.
authors.forename: Alois
authors.initials: A
authors.lastname: Lang
authors.affiliation: Abteilung für Interne 1, Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors.forename: Holger
authors.initials: H
authors.lastname: Rumpold
authors.affiliation: Universitätsklinik für Innere Medizin V, MedUni Innsbruck, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Steurer
authors.affiliation: Bristol-Myers Squibb, Wien, Austia.
authors.forename: Houman
authors.initials: H
authors.lastname: Kamali
authors.affiliation: Medizinische Klinik I, Westpfalz-Klinikum, Kaiserslautern, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Link
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control*; D001317:Austria; D019587:Dietary Supplements / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D007501:Iron / Q000378:metabolism* / Q000627:therapeutic use*; D008495:Medical Oncology / Q000592:standards; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D007501:Iron
keywords: Functional and absolute iron deficiency; Iron deficiency; Iron supplementation; Recommendations for clinical practice; Tumor anemia