Journal of Blood Disorders & Transfusion

Abstract

Single Dose Preoperative Administration of Intravenous Iron Corrects Iron Deficiency Anaemia in Colorectal Cancer

J A D Simpson, S L Ng, M J Brookes and A G Acheson

Preoperative iron defi ciency anaemia (IDA) is common and associated with poor postoperative outcomes. Standard treatment includes allogenic blood transfusion or oral iron supplementation, but new intravenous iron strategies have shown promise in the perioperative setting. We aim to assess the feasibility and effect of a single dose of intravenous iron in treating preoperative colorectal cancer related anaemia.

We performed an open labelled phase I uncontrolled trial. Patients with a diagnosis of colorectal cancer and biochemically proven IDA received intravenous iron a minimum of 14 days prior to surgery. Blood parameters including haemoglobin values were measured at pre-dose and preoperative time points.

Eight of the ten patients responded to intravenous iron supplementation with a mean preoperative rise in haemoglobin of 1.1 g/dl (p=0.036). Ferritin levels rose by a mean of 523.4ng/ml across the ten patients. No adverse events occurred in any of the trial patients.

This trial demonstrates that intravenous iron is both a feasible and effective treatment for IDA in anaemic colorectal cancer patients. However two patients did not respond to treatment, highlighting the need to identify biochemical markers which will accurately predict the underlying cause for anaemia and response to treatment.