The Effect of Intravenous Iron Therapy in Chemotherapy-Induced Anemia in Patients with Non-metastatic Breast Cancer

Abstract

Background: Chemotherapy-induced anemia (CIA) is a common phenomenon in patients with solid cancer, and it might respond to intravenous iron therapy with or without treatment with an erythropoiesis-stimulating agent (ESA). Methods: This study was a cross-sectional study conducted at Motahari Clinic in Shiraz from March 20, 2022, to March 20, 2023. Using the census method, 91 non-metastatic breast cancer patients participated, of them 60 patients met the inclusion criteria to enter the study, and only 45 patients developed CIA in our study. The same percentage of patients had absolute iron deficiency anemia (AIDA; 12 patients) and classic functional iron deficiency anemia (FIDA; 12 patients) (35.3%), and 29.4% (12 patients) were possible FIDA. They underwent IV iron therapy and were evaluated 4 - 6 weeks later. Results: We did not find a significant association between menopausal status (P = 0.372), disease subtypes (P = 0.971), stage of disease (P = 0.891), cycles of chemotherapy (P = 0.124), and chemotherapy types (P = 0.22) with CIA. However, there was a statistically significant relation between mean hemoglobin variations with intravenous iron therapy (P = 0.001), and this variation was more significant in patients with AIDA compared to possible and classic FIDA (1.02 ± 0.87 compared to 0.22 ± 1.04 and 0.81 ± 0.65, respectively). Conclusions: We concluded that intravenous iron therapy is effective for the treatment of CIA in breast cancer patients with AIDA and probably in classic FIDA patients. However, more studies with larger sample sizes can be performed in the future to confirm or reject our claim.