Intravenous iron therapy for treating patients with iron deficiency anaemia during the perioperative period of gynecological malignancy

Zhizhi Deng(1), Xi Zhou(2), Guicheng He(3), Na Yang(4), Jiming Zhou(5),


(1) Gynecology &Obstetrics and Reproductive Medical Center,The First Affiliated Hospital, Hengyang Medical School,University of South China
(2) Gynecology &Obstetrics and Reproductive Medical Center,The First Affiliated Hospital, Hengyang Medical School,University of South China
(3) Department of Medical Oncology, The First Affiliated Hospital,Hengyang Medical School,University of South China
(4) Gynecology &Obstetrics and Reproductive Medical Center,The First Affiliated Hospital, Hengyang Medical School,University of South China
(5) Department of Cardiology, The First Affiliated Hospital,Hengyang Medical School,University of South China
Corresponding Author

Abstract


Anaemia is a common phenomenon in patients with malignant gynecological tumors. The occurrence of anaemia in the perioperative period leads to an increased probability of blood transfusion, increased surgical complications,poor wound healing, prolonged hospitalization, increased medical costs, and increased mortality. Intravenous iron, which is known for its rapid onset and lack of gastrointestinal side effects, has become increasingly prevalent in clinical practice. A total of 300 patients with gynaecological malignancies were admitted to The First Affiliated Hospital,Hengyang Medical School,University of South China between January, 2019 and December , 2021. Anaemia was assessed during routine blood tests by measuring red blood cell (RBC) counts, hemoglobin (Hb) levels, haematocrit (HCT) values, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). The postoperative blood transfusion rate, transfusion volume, infection rate, and hospitalization duration were also recorded and comparisons were made between the control and treatment groups.Our study showed that preoperative intravenous iron injection can effectively increase haemoglobin levels in patients with anemia caused by gynecological cancer, reduces the probability of perioperative blood transfusion., decreases postoperative complications and infection rates, shortens hospital stays, and improves short-term prognosis in patients. We concluded that intravenous iron presents is a valuable clinical option for addressing perioperative anaemia in patients with gynecologic malignancies.

References


Hufnagel D H, Mehta S T, Ezekwe C, Gadd S A, Parwani M,

Littell R D, Butler K A, Mutch D G and Hagemann

A R. Prevalence of Anemia and Compliance With

NCCN Guidelines for Evaluation and Treatment of

Anemia in Patients With Gynecologic Cancer[J]. J

Natl Compr Canc Netw, 2021,19(5):513-520.

Davidson E M, Scoullar M, Peach E, Fortes J, Ntambi J,

Stephenson K, Vogel J P, Rogne T and Black R E.

Quantifying differences in iron deficiencyattributable anemia during pregnancy and

postpartum[J]. Cell Rep Med, 2023,4(7):101097.

M. Muñoz, A. G. Acheson, M. Auerbach, M. Besser, O.

Habler, H. Kehlet, G. M. Liumbruno, S. Lasocki, P.

Meybohm, R. Rao Baikady, T. Richards, A.

Shander, C. So-Osman, D. R. Spahn, A. A. Klein.

International consensus statement on the perioperative management of anaemia and iron

deficiency[J]. Anaesthesia, 2017,72(2):233-247.

Marn H, Critchley J A. Accuracy of the WHO

Haemoglobin Colour Scale for the diagnosis of

anaemia in primary health care settings in lowincome countries: a systematic review and metaanalysis[J]. Lancet Glob Health, 2016,4(4):e251-

e265.

Cappellini M D, Santini V, Braxs C, Novelli S, Amato A,

Pasquale P, Casini A, Camaschella C. Iron

metabolism and iron deficiency anemia in

women[J]. Fertil Steril, 2022,118(4):607-614.

Leung A, Lam J M, Wong A, Ho K K, Lau Y M, Ma Y K,

Tsang S, Lee W W, Chan P C.Iron Deficiency

Anemia: An Updated Review[J]. Curr Pediatr Rev,

,20(3):339-356.

Pecher A C, Bach S, Pauluschke-Frohlich J, Kim M S, Chae

J H, Ruhlmann V, Sticherling M, Stamer U. Anemia

and iron deficiency in pregnant women with

rheumatic diseases[J]. Joint Bone Spine,

,91(1):105650.

Moisidis-Tesch C M and Shulman L P. Iron Deficiency in

Women's Health: New Insights into Diagnosis and

Treatment[J]. Adv Ther, 2022,39(6):2438-2451.

Madeddu C, Neri M, Sanna E, Dettori M, Solinas G, Spada P,

Palmas A, Murtas R, Cau T and Pinna G.

Experimental Drugs for Chemotherapy- and

Cancer-Related Anemia[J]. J Exp Pharmacol,

,13:593-611.

Park J Y, Kang O J, Lee Y Y, Chang S J, Ryu H S, Lee E J,

Nam J H and Bae D S. A prospective randomized

controlled trial evaluating the safety and efficacy of

patient blood management program in patients with

gynecologic cancer (KGOG 4011/PBM)[J]. Int J

Gynecol Cancer, 2023,33(7):1140-1144.

Hufnagel D H, Bos L M, Brown A J, Gadd S A, Parwani M,

Littell R D, Butler K A, Mutch D G and Hagemann

A R. Compliance With NCCN Guidelines for

Evaluation and Treatment of Anemia Among

Patients With Solid Tumors[J]. J Natl Compr Canc

Netw, 2024,22(3).

Macdougall I C, Comin-Colet J, Breymann C, Spahn D R,

Gaillard C A, Van Wyck D B, Roubert B,

Mezzacasa A and Glaspy J. Iron Sucrose: A Wealth

of Experience in Treating Iron Deficiency[J]. Adv

Ther, 2020,37(5):1960-2002.

Kalra P R, Cleland J, Petrie M C, Ford I, Macdougall

I C, Taylor J, McDonagh T, Walker A, Bunting K

V, Perrins J, Robertson M, Sim D, Norrie J, Wong

K, Rossignol P, Desai A S, Lund L H, Swedberg K,

Zieroth S, Stiles M and Wong M C. Intravenous

ferric derisomaltose in patients with heart failure and

iron deficiency in the UK (IRONMAN): an

investigator-initiated, prospective, randomised,

open-label, blinded-endpoint trial[J]. Lancet,

,400 (10369): 2199- 2209.

Pai R D, Chong Y S, Clemente-Chua L R, Teo Y L, Ngan

Kee W, Tang S Y, Wong S H, Chen H L, Goh J T

W, Lee P, Abu Bakar M A, Wong P C, Tsang S H,

Loke W M, Oi S S, Tseng W W, Norhasmah S,

Viswanathan S and Tan K H. Prevention and

Management of Iron Deficiency/Iron-Deficiency

Anemia in Women: An Asian Expert Consensus[J].

Nutrients, 2023,15(14).

Kadioglu N, Oskovi K Z, Sariaslan S, Ozenoglu A and

Yildizhan B.A retrospective analysis of the women

hospitalized and treated due to anemia caused by

gynecological pathologies: the role of intravenous

iron (ferric carboxymaltose) and blood transfusion

in clinical practice[J]. Minerva Obstet Gynecol,

,75(5):399-404.

Shander A, Corwin H L, Meier J, Spahn D R, Weiskopf R

B, Hardy J F, Henry D A, Shulman I A, Waters J H,

Munoz M, Leahy M, Goodnough L T, KozekLangenecker S, Mallett S V, Gombotz H, Solomon

C, Barash P, Erhard J and Gorlin J B.

Recommendations From the International

Consensus Conference on Anemia Management in

Surgical Patients (ICCAMS)[J]. Ann Surg,

,277(4):581-590.

Campos-Aguirre E, Bravo-Acevedo A and Benitez-Arvizu

G. [Iron in pre-operative stage and transfusion in

patients undergoing hysterectomy][J]. Rev Med Inst

Mex Seguro Soc, 2023,61(Suppl 3):S453-S459.

Hare G and Mazer C D. Anemia: Perioperative Risk and

Treatment Opportunity[J]. Anesthesiology,

,135(3):520-530.

Gomez-Ramirez S, Jerico C and Munoz M. Perioperative

anemia: Prevalence, consequences and

pathophysiology[J]. Transfus Apher Sci,

,58(4):369-374.

Pandey A K, Gautam D, Tolani H, Prakash S, Srivastava A,

Gupta S and Singh A K. Clinical outcome post

treatment of anemia in pregnancy with intravenous

versus oral iron therapy: a systematic review and

meta-analysis[J]. Sci Rep, 2024,14(1):179.

Ali S A, Razzaq S, Aziz S, Khan H, Farooq S, Tariq S,

Shabbir S and Zafar H. Role of iron in the reduction

of anemia among women of reproductive age in

low-middle income countries: insights from

systematic review and meta-analysis[J]. BMC

Womens Health, 2023,23(1):184.


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