Abstract CN84
Background
Anaemia and iron deficiency affect a high proportion of patients with cancer, especially when undergoing treatment with systemic anti-cancer therapies (SACT) and are associated with fatigue, reduced quality of life & reduced performance status. Over the past 4 years, the Oncology DTU has continuously reviewed the managment of patients with anaemia and in particular the need to diagnose iron deficiency at time of starting SACT and recently the same guidance were introduced for Haemato-Oncology patients. Routine blood testing of Transferrin Saturation (TSAT) and serum ferritin is performed on all patients at time of starting SACT, those diagnosed with iron deficiency anaemia are treated with an intravenous iron infusion. During this time, various logistical challenges, learning and updates to local guidance has led to a more robust process, now in place to manage this patient group.
Methods
Cancer patients attending for cycle 1 day 1 SACT have their TSAT and serum ferritin levels measured, if diagnosed with iron deficiency (ie TSAT <20% and serum ferritin <100ug/L, patients will receive an intravenous iron infusion. In March 2022, an audit of 141 new oncology referrals for SACT and 11 patients who received a blood transfusion was conducted for compliance to local guidance.
Results
Logistical challenges included: update and approval of local guidelines, education of all members of the Health Care Team re: prescribing, contraindications and side-effects of iron infusions, patient education. Wider issues, include: COVID, staffing. 129/141 patients had TSAT and serum ferritin levels checked, of these 57 patients were diagnosed as iron deficient, with 54 patients then receiving an iron infusion. Analysis of further results is still underway.
Conclusions
Whilst this is a very small audit, it demonstrates the importance of considering iron deficiency as an underlying cause of anaemia in patients with cancer, who are starting SACT and can ensure patients receive the most appropriate supportive treatment for their needs. Through our experiences, with the support of our haematology consultant, this service is predominantly nurse led and continues to develop.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.