PMID- 24812134
OWN - NLM
STAT- MEDLINE
DCOM- 20141231
LR  - 20190918
IS  - 1540-1413 (Electronic)
IS  - 1540-1405 (Linking)
VI  - 12
IP  - 5
DP  - 2014 May
TI  - Should the ASCO/ASH Guidelines for the use of intravenous iron in cancer- and 
      chemotherapy-induced anemia be updated?
PG  - 657-64
AB  - Coadministration of intravenous (IV) iron improves responses to 
      erythropoiesis-stimulating agents (ESAs) in the treatment of cancer-associated 
      (CAA) and chemotherapy-induced anemia (CIA). Twelve prospective studies have 
      demonstrated synergy between parenteral iron and ESAs, with variable degrees of 
      improved hemoglobin (Hgb) response rates, shorter times to target Hgb levels, and 
      a lower ESA dose required for equivalent Hgb responses. Clinically significant 
      adverse events (AEs) with currently available IV iron products are uncommon. 
      Pretreatment serum hepcidin levels may predict response magnitude. Safety 
      concerns among many oncologists are driven by reports of serious AEs from older 
      IV iron formulations that are no longer available, and misinterpretation of the 
      nature and frequency of minor infusion reactions. Premedication with 
      antihistamines is of unproven benefit and can cause symptoms that mimic 
      anaphylaxis, prompting intervention with vasopressors and converting self-limited 
      reactions into hemodynamically significant AEs. Payer rules proscribing the 
      administration of ESAs and IV iron on the same day also have limited the clinical 
      adoption of IV iron and ESA coadministration. At a time when financial resources 
      are scarce, the ability to reduce use of costly ESAs is beneficial. Despite a 
      favorable risk/benefit ratio for IV iron in CAA and CIA, current IV iron 
      recommendations in guidelines from ASCO/ASH, NCCN, and ESMO are inconsistent. The 
      authors believe more routine use of IV iron for CAA and CIA is appropriate in 
      view of existing evidence, and suggest reconsideration of the current ASCO/ASH 
      guidelines, which state "there is insufficient evidence to consider the use of 
      intravenous iron as a standard of care."
FAU - Gafter-Gvili, Anat
AU  - Gafter-Gvili A
AD  - From aInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, 
      Petah-Tikva, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, 
      Israel; bDana-Farber Cancer Institute and Harvard Medical School, Boston, 
      Massachusetts; and cGeorgetown University School of Medicine, Washington, DC.
FAU - Steensma, David P
AU  - Steensma DP
FAU - Auerbach, Michael
AU  - Auerbach M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Natl Compr Canc Netw
JT  - Journal of the National Comprehensive Cancer Network : JNCCN
JID - 101162515
RN  - 0 (Antineoplastic Agents)
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - Administration, Intravenous
MH  - Anemia/chemically induced/*therapy
MH  - Antineoplastic Agents/adverse effects
MH  - Humans
MH  - Iron/*administration & dosage
MH  - Neoplasms/*drug therapy
MH  - *Practice Guidelines as Topic
EDAT- 2014/05/09 06:00
MHDA- 2015/01/01 06:00
CRDT- 2014/05/10 06:00
PHST- 2014/05/10 06:00 [entrez]
PHST- 2014/05/09 06:00 [pubmed]
PHST- 2015/01/01 06:00 [medline]
AID - 12/5/657 [pii]
AID - 10.6004/jnccn.2014.0069 [doi]
PST - ppublish
SO  - J Natl Compr Canc Netw. 2014 May;12(5):657-64. doi: 10.6004/jnccn.2014.0069.