Ferric carboxymaltose reduces the number of red blood cell units transfused and allows transfusion independence to be obtained in patients with iron deficiency anemia secondary to gastrointestinal chronic blood loss.
The aim of this study was to evaluate the effectiveness of ferric carboxymaltose (FCM) in patients with iron deficiency anemia (IDA) secondary to gastrointestinal chronic blood loss (CBL), who received chronic transfusion support.



We retrospectively evaluated 38 patients with IDA (hemoglobin [Hb] < 10 g/dL and ferritin < 12 ng/mL or transferrin saturation [TSAT] < 16%) refractory or intolerant to oral iron therapy that necessitated transfusion support in the previous 12 months. They were treated with FCM (500-2500 mg). The primary endpoint was to evaluate the reduction of transfusion requirements (red blood cell [RBC] units) after FCM treatment.



The median age of the cohort was 78 years, with a male:female ratio of 22:16. Before FCM treatment a median of 6 RBC units had been transfused. At the treatment (T0) the median value of Hb was 8.7 g/dL, the TSAT 6%, and ferritin 12 ng/mL. The median FCM dose was 1000 mg. At 5 weeks from T0 the median Hb level was 11 g/dL, with a median increase of 2.4 g/dL. With a median follow-up of 326 days, the median transfusion requirement was 0 RBC units, significantly lower than before T0 (p < 0.001). Overall 17 patients still necessitated transfusion support. Twenty-three patients needed retreatment with FCM for recurrence of IDA: 10 of them obtained a response again. The percentage of transfusion-independent patients at median follow-up was equal to 52%.



In patients with IDA secondary to CBL, FCM significantly reduces the need of transfusions and achieves transfusion independence in half of the cases.
Immunohaematology and Transfusion Service, Bozen/Bolzano Hospital, Bozen/Bolzano, Italy.
Ugo
U
Salvadori
Centre for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bozen/Bolzano, Italy.
Marco
M
Sandri
Transfusion Medicine Department, Udine University Hospital, Udine, Italy.
Cristina
C
Melli
Immunohaematology and Transfusion Service, Mestre Hospital, Mestre, Venezia, Italy.
Francesca
F
Polese
Transfusion Service, San Donà di Piave Hospital, San Donà di Piave, Italy.
Maria
M
Simeoni
Transfusion Service, Belluno Hospital, Belluno, Italy.
Stefano
S
Capelli
Immunohaematology and Transfusion Service, Bozen/Bolzano Hospital, Bozen/Bolzano, Italy.
Ahmad
A
Al-Khaffaf
D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000150:complications*; D006801:Humans; D008297:Male; D008320:Maltose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies
D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose