Iron metabolism and iron supplementation in cancer patients

Wien Klin Wochenschr. 2015 Dec;127(23-24):907-19. doi: 10.1007/s00508-015-0842-3. Epub 2015 Sep 15.

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.

Keywords: Functional and absolute iron deficiency; Iron deficiency; Iron supplementation; Recommendations for clinical practice; Tumor anemia.

Publication types

  • Review

MeSH terms

  • Anemia, Iron-Deficiency / etiology
  • Anemia, Iron-Deficiency / metabolism*
  • Anemia, Iron-Deficiency / prevention & control*
  • Austria
  • Dietary Supplements / standards*
  • Evidence-Based Medicine
  • Humans
  • Iron / metabolism*
  • Iron / therapeutic use*
  • Medical Oncology / standards
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Neoplasms / metabolism*
  • Practice Guidelines as Topic
  • Treatment Outcome

Substances

  • Iron