Clinical and economic benefits of parenteral iron carboxymaltosate in patients with gynecological cancers: A retrospective observational study

Abstract

Background. Timely diagnosis and treatment of iron deficiency anemia in cancer patients affect the quality of life and the effectiveness of anti-tumor treatment. However, choosing a method for correcting anemia is imperative to achieve maximum efficiency and safety with the least financial costs. Aim. To evaluate postoperative methods for treating iron deficiency anemia in patients with gynecological cancers based on a comparative analysis of the clinical and economic outcomes of intravenous iron carboxymaltosate and blood transfusions. Materials and methods. A study of 125 cases of malignant neoplasms of the female reproductive system with a history of iron deficiency anemia was conducted. Study Group 1 included 85 patients with malignancies receiving 500–1000 mg of iron carboxymaltosate (ICM) intravenously; Group 2 included 40 patients with transfusion of packed red cells (PRC). Clinical and economic outcomes of methods for anemia treatment were analyzed. Results. In Group 1, the maximum increase in hemoglobin level was observed from Week 2 of ICM treatment (median increase 1.3 g/dL) peaking by Week 9–10 (median increase 2.3 g/dL). In Group 2 the maximum increase in hemoglobin level was noted at Week 1 after PRC transfusion (median increase 2.1 g/dL), with a gradually decreasing hemoglobin level for 3 weeks after that. No side effects of ICM treatment were reported. In 7 (17.5%) patients, a pyrogenic reaction (hyperthermia) was reported after a blood transfusion. The median time from surgery to the beginning of anti-tumor treatment (radiation therapy, chemotherapy) in Group 1 was 19 days [17; 25] vs. 26 days [22; 30] in Group 2 (p=0.0021). Conclusion. High-dose ICM therapy for iron deficiency anemia in patients with gynecological malignancies is cost-effective and shows a long-term clinical effect.