Guidelines for Complications of Cancer Treatment Vol VIII Part B

Table 3. Improvements in Hemoglobin Levels WithDarbopoietin vs Epoetin Alfa [27]Treatment Arm Mean Change Patients Achievingin Hemoglobin ResponseGroup 1 1.35 g/dL 59%Group 2 1.35 g/dL 58%Group 3 1.28 g/dL 65%Group 4 1.03 g/dL 49%Glaspy JA, et al. Cancer. 2003; 97:1312-1320.Iron TherapyIron deficiency is a reality in patients with cancer and it isimperative to identify and replenish the same when adoptingother measure to correct anemia of cancer. Even though thereis an element of impaired iron absorption, utilization andmetabolism in cancer patients oral iron intake can be useful.However poor compliance to oral therapy is met with due toGI disturbances induced by oral iron make it a less attractiveoption. Under the circumstances options of parenteral irontherapy has been used to good effect. With the currentavailability of iron sucrose, the toxicity associated withparenteral iron therapy are less frequent. Auerbach [26]compared the utility of oral iron versus IV iron versus no ironat all in cancer patients. Iron dextran was given either as bolusdose or as an infusion. There were statistically significantdifferences in mean end point hemoglobin levels between theIV bolus group and the no-iron arm. The mean Hb increasefor both the IV iron groups were significantly higher than theno-iron and oral iron arms (P < .02). However there was nodifference between the no-iron and oral iron groups suggestingpoor results with oral therapy [26] . In another study Henry et alcompared ferric gluconate infusion once weekly with oral ironand no supplementation. There was a significantly largerincrease in mean Hb from baseline to end point in the infusional485