Iron deficiency during first-line chemotherapy in metastatic cancers: a prospective epidemiological study

• Published in: Supportive care in cancer Vol. 28; no. 4; pp. 1639 - 1647
• Main Authors: Saint, Angélique, Viotti, J., Borchiellini, D., Hoch, B., Raimondi, V., Hebert, C., Largillier, R., Evesque, L., Follana, P., Ferrero, J. M., Delaby, C., Schiappa, R., Chamorey, E., Barriere, J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2020; Springer; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Anemia; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - chemically induced; Anemia, Iron-Deficiency - epidemiology; Cancer; Chemotherapy; Cohort Studies; Colorectal cancer; Epidemiology; Female; Ferric carboxymaltose; Humans; Iron; Iron - deficiency; Iron deficiency anemia; Iron Metabolism Disorders - blood; Iron Metabolism Disorders - chemically induced; Iron Metabolism Disorders - epidemiology; Male; Medical care; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neoplasms - drug therapy; Neoplasms - epidemiology; Non-Hodgkin's lymphomas; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Prevalence; Prospective Studies; Quality management; Quality of Life; Rehabilitation Medicine; Tumors; Iron supplementation; Anemia; Epidemiology; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-04938-3

Purpose Anemia is common in oncology and negatively impacts quality of life. However, there is lack of knowledge about iron deficiency (ID) epidemiology. The aim of this study was to prospectively assess iron status in patients with locally advanced or metastatic cancer beginning chemotherapy. Methods In this prospective, multicenter cohort study, anemia and ID were evaluated in patients with locally advanced or metastatic solid tumors and lymphoma before starting chemotherapy. Blood samples were collected at inclusion (W0), 6 weeks (W6), and 12 weeks (W12). Prevalence was evaluated in the general population, according to tumor location and was correlated with tumor response. Results One hundred twenty-nine patients were enrolled between 2013 and 2015; 119 had solid tumors and 10 lymphomas. At W0, there were no significant difference between locations with a prevalence around 50–60% (range 47.2–70.4%) and only a trend for colorectal cancer (70.4%, P  = 0.069) due to a higher prevalence of absolute ID (18.5%). Prevalence of ID+ decreased between W0 and W6 and remained stable until W12 due to the proportion of patients with ID and without anemia. However, anemia prevalence increased during W0 and W6 and remained stable to W6 from W12 due to patients with anemia but without ID. A significant correlation between tumor response and ID prevalence was found ( P  = 0.036). Conclusions We confirm the high prevalence of ID and anemia in cancer patients. ID status is correlated to tumor response providing a strong rationale for iron monitoring during cancer management.