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Christopher A. Laman, Scott B. Silverstein and George M. Rodgers

Many patients require parenteral iron therapy for optimal correction of anemia, including cancer patients who require erythropoietic drugs. Available parenteral iron therapy options include iron dextran, iron gluconate, and iron sucrose. The purpose of this study is to summarize our institution's experience with parenteral iron therapy over a 5-year period, with a focus on comparative safety profiles. All patients receiving parenteral iron therapy over this period were included in the analysis. Chi-squared test and Fisher's exact test were used to compare the adverse event rates of each product. A total of 121 patients received 444 infusions of parenteral iron over this period. Iron dextran was the most commonly used product (85 patients) and iron sucrose was the least used (2 patients). Iron gluconate was used by 34 patients. Overall adverse event rates per patient with iron dextran and iron gluconate were 16.5% and 5.8%, respectively (P = .024). Premedication with diphenhydramine and acetaminophen before infusions of iron dextran reduced adverse event rates per infusion from 12.3% to 4.4% (P = .054). Test doses of iron dextran were used 88% of the time for initial infusions of iron dextran. All adverse events for all parenteral iron products were mild or moderate. There were no serious adverse events and no anaphylaxis was observed. Our results suggest that, if test doses and premedications are used, iron dextran is an acceptable product to treat iron deficiency.

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Michael Auerbach and Harold Ballard

Edited by Kerrin G. Robinson

the American Society of Hematology 45th Annual Meeting and Exposition; San Diego, California; December 6–9, 2003 . 7. Chandler G Harchowal J Macdougall IC . Intravenous iron sucrose: establishing a safe dose . Am J Kidney Dis 2001 ; 38

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Anat Gafter-Gvili, David P. Steensma and Michael Auerbach

-molecular-weight iron dextran (HMW ID), low-molecular-weight (LMW) ID, ferric gluconate, iron sucrose, and 3 newer formulations: ferumoxytol, ferric carboxymaltose, and iron isomaltoside, which features tighter elemental iron binding to novel carbohydrate cores and can

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Jeffrey A. Gilreath, Daniel S. Sageser, James A. Jorgenson and George M. Rodgers

. Chandler G Harchowal J Macdougall IC . Intravenous iron sucrose: establishing a safe dose . Am J Kid Dis 2001 ; 38 : 988 – 991 . 39. Deicher R Ziai F Cohen G . High-dose parenteral iron sucrose depresses neutrophil intracellular killing

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Jennifer M. Hinkel, Edward C. Li and Stephen L. Sherman

products available on the market, iron dextran, iron sucrose, and sodium ferric gluconate, are not specifically approved for the oncology context and are associated with various risks. A survey of NCCN pharmacy directors, described in detail later

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Jeffrey Crawford and George M. Rodgers

Chemotherapy-Induced Anemia recommends 3 products: low-molecular-weight iron dextran, ferric gluconate, and iron sucrose. The panel does not recommend high-molecular-weight iron dextran (safety reasons) or ferumoxytol (lack of data in patients with cancer

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Jeffrey A. Gilreath, David D. Stenehjem and George M. Rodgers

Benefits of TDI in Patients With Cancer Treating CIA with intravenous iron is well supported in the oncology literature. LMW iron dextran (TDI and intermittent bolus), ferric gluconate, and iron sucrose all improve erythropoiesis in combination with ESAs

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George M. Rodgers III, Pamela Sue Becker, Morey Blinder, David Cella, Asher Chanan-Khan, Charles Cleeland, Peter F. Coccia, Benjamin Djulbegovic, Jeffrey A. Gilreath, Eric H. Kraut, Ursula A. Matulonis, Michael M. Millenson, Denise Reinke, Joseph Rosenthal, Rowena N. Schwartz, Gerald Soff, Richard S. Stein, Gordana Vlahovic and Alva B. Weir III

-molecular-weight iron dextran, ferric gluconate, and iron sucrose). 73 Evidence from 5 published studies using iron in conjunction with an ESA suggests that intravenous iron is superior to oral iron. 74 – 78 Patients participating in these trials had serum ferritin