IV iron may reduce thromboembolism risk in chemotherapy patients
MedWire News: Administering intravenous (iv) iron may reduce the risk for venous thromboembolism (VTE) in patients with chemotherapy-induced anemia (CIA), US study findings suggest.
The authors recommend "a retrospective review of other ESA [erythropoietic-stimulating agents] clinical trials to see if this hypothesis can be confirmed, especially in other iv iron trials similar to ours."
David Henry (Pennsylvania Hospital, Philadelphia) and team retrospectively analyzed the rates of VTE development among 187 cancer patients with CIA over an 8-week period. The patients had a mean age of 65 years.
Sixty-three patients were randomly allocated to receive treatment with iv ferric gluconate 125 mg weekly, 61 were allocated to oral ferrous sulfate 325 mg three times daily, and 63 received no iron therapy at all.
By the end of the study period, a total of 29 VTEs had occurred in 19 patients.
Of these events, seven occurred in the iv iron group, 11 in the oral iron group, and 11 in the iron-free group. Furthermore, patients with a platelet count of 350,000 cells per µL or more had a 2.9-fold higher risk for VTE development than all other patients, irrespective of the potential side effects of platinum-based chemotherapy agents.
Writing in the American Journal of Hematology, Henry and team report that patients treated with iv iron were less likely to have a platelet count of 350,000 cells per µL or more than those not receiving iv iron, as reflected by an odds ratio of 0.7.
This, they say, implies that iv iron may protect against VTE in CIA patients.
To determine the mechanism by which iv iron reduces VTE risk, the team adjusted the findings for the presence of a platelet count of 350,000 cells per µL or higher. Henry et al found that when this adjustment was made, iv iron therapy no longer predicted VTE risk.
This suggests "that the decrement observed was likely mediated through its [iv iron] effects on platelet count," say Henry and colleagues.
They conclude that these findings may help improve strategies for minimizing VTE risk in cancer patients.
By Lauretta Ihonor