Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Nutr Cancer. 2020;72(5):864-872. doi: 10.1080/01635581.2019.1658794. Epub 2019 Sep 2.
Anemia is a prevalent complication in patients with cancer, both at diagnosis and during treatment, with notable negative effects on quality of life and overall prognosis. Iron deficiency is the most common cause of anemia in the patients and can affect almost half of patients with solid and hematologic malignancies. The pathogenesis is complex and multifactorial, including bleeding, malnutrition, medications, and inflammation resulted from cancer and cancer treatment. In fact, either absolute or functional iron deficiency can occur. Most iron deficient cancer patients present with functional iron deficiency, a condition with adequate iron storage but insufficient iron supply for erythroblasts and other iron dependent tissues. Functional iron deficiency is the result of the cancer related cytokine release, but in absolute iron deficiency iron reserves are depleted leading to similar but often more severe symptoms of inadequate iron store. Current therapeutic options in cancer anemia consist of iron administration, erythropoietic stimulating agents, and blood transfusion. The latter should be administered to a minimum, because of problems regarding risks. Here, we present a review on the epidemiology, pathophysiology, clinical outcomes, and therapeutic options of iron deficiency as well as the effect of iron therapy on tumor progression in anemic cancer patients.
贫血是癌症患者在诊断和治疗期间普遍存在的并发症，对生活质量和总体预后有显著的负面影响。缺铁是这些患者贫血的最常见原因，几乎半数实体瘤和血液恶性肿瘤患者会受到影响。发病机制复杂且多因素，包括出血、营养不良、药物以及癌症和癌症治疗引起的炎症。事实上，可能会出现绝对或功能性缺铁。大多数缺铁性癌症患者表现为功能性缺铁，这种情况铁储存充足，但红系前体细胞和其他依赖铁的组织的铁供应不足。功能性缺铁是由癌症相关细胞因子释放引起的，但在绝对缺铁时，铁储备会耗尽，导致类似但通常更严重的缺铁症状。癌症相关性贫血的当前治疗选择包括铁剂治疗、促红细胞生成素刺激剂和输血。由于存在风险问题，应尽量减少输血。在这里，我们对缺铁的流行病学、病理生理学、临床结局和治疗选择以及铁治疗对贫血癌症患者肿瘤进展的影响进行了综述。
