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. 2013 Jul;24(7):1886-1892.
doi: 10.1093/annonc/mdt118. Epub 2013 Apr 7.

Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia

H Ludwig  1 , E Müldür  2 , G Endler  3 , W Hübl  3
Affiliations

Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia

H Ludwig et al. Ann Oncol. 2013 Jul.

Abstract

Background: Only limited data on the prevalence of iron deficiency (ID) and its correlation with clinical parameters are available in cancer. ID frequently contributes to the pathogenesis of anemia in patients with cancer and may lead to several symptoms such as impaired physical function, weakness and fatigue.

Patients and methods: Parameters of iron status and clinical parameters were evaluated in 1528 patients with cancer who presented consecutively within a four-month period at our center. One thousand fifty-three patients had solid tumors and 475 hematological malignancies.

Results: ID [transferrin saturation (TSAT) < 20%] was noted in 645 (42.6%) of the 1513 patients with TSAT tests available and 500 (33.0%) were anemic. ID rates were highest in pancreatic (63.2%), colorectal (51.9%) and lung cancers (50.7%). Of the 409 iron-deficient patients in whom serum ferritin levels were available additionally to TSAT, 335 (81.9%) presented with functional ID (FID) (TSAT < 20%, serum ferritin ≥30 ng/ml) and 74 (18.1%) with absolute ID. In patients with solid tumors, prevalence of ID correlated with cancer stage at diagnosis (P = 0.001), disease status (P = 0.001) and ECOG performance status (P = 0.005).

Conclusions: ID was frequently noted in cancer and was associated with advanced disease, close proximity to cancer therapy, and poor performance status in patients with solid tumors.

Keywords: absolute iron deficiency; cancer-related anemia; chemotherapy-induced anemia; functional iron deficiency; iron deficiency; iron deficiency anemia.

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Figures

Figure 1.
Figure 1.
(A) Prevalence of ID and anemia across different tumor types in patients with available TSAT and Hb (n = 1509). (B) Prevalence of ID and anemia in relation to stage in patients with solid tumors and (C) in patients with hematological malignancies. (D) Correlation of ID and anemia with ECOG performance status in patients with solid tumors and (E) in those with hematological malignancies.
See this image and copyright information in PMC

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