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World J Gastroenterol. Feb 28, 2014; 20(8): 1972-1985
Published online Feb 28, 2014. doi: 10.3748/wjg.v20.i8.1972
Published online Feb 28, 2014. doi: 10.3748/wjg.v20.i8.1972
Perioperative anemia management in colorectal cancer patients: A pragmatic approach
Manuel Muñoz, Transfusion Medicine, School of Medicine, University of Málaga, 29071-Málaga, Spain
Susana Gómez-Ramírez, Internal Medicine, University Hospital Virgen de la Victoria, 29071-Málaga, Spain
Elisa Martín-Montañez, Department of Pharmacology, School of Medicine, University of Málaga, 29071-Málaga, Spain
Michael Auerbach, Georgetown University School of Medicine, Washington, DC 20057, United States
Author contributions: All the authors contributed equally on conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
Correspondence to: Manuel Muñoz, Professor, Transfusion Medicine, School of Medicine, University of Málaga, Campus de Teatinos, s/n. 29071-Málaga, Spain. mmunoz@uma.es
Telephone: +34-952-131540 Fax: +34-952-1315340
Received: September 17, 2013
Revised: December 21, 2013
Accepted: January 19, 2014
Published online: February 28, 2014
Revised: December 21, 2013
Accepted: January 19, 2014
Published online: February 28, 2014
Core Tip
Core tip: Anemia, usually due to iron deficiency, is highly prevalent among patients with colorectal cancer. Both anemia and allogeneic blood transfusion are associated with poorer outcomes. Anemia management, within a multidisciplinary, multimodal, individualized strategy to minimize or eliminate allogeneic blood transfusion, is indicated to improve outcomes. Intravenous iron is safe and effective but underused, despite the extremely low risk of causing serious adverse events. Newer intravenous iron formulations allow complete replacement dosing in 15-60 min markedly facilitating care. Erythropoiesis stimulating agents may improve response rates.