Management of iron deficiency anemia

A survey of pediatric hematology/oncology specialists

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Iron deficiency anemia (IDA) is the most common hematologic condition in children and adolescents in the United States (US). No prior reports have described the management of IDA by a large cohort of pediatric hematology/oncology specialists. Procedure: A 20-question electronic survey that solicited responses to two hypothetical cases of IDA was sent to active members of the American Society of Pediatric Hematology/Oncology (ASPHO) in the US. Results: Of 1,217 recipients, 398 (32.7%) reported regularly treating IDA and completed the survey. In a toddler with nutritional IDA, 15% (N=61) of respondents reported ordering no diagnostic test beyond a complete blood count. Otherwise, wide variability in laboratory testing was reported. For treatment, most respondents would prescribe ferrous sulfate (N=335, 84%) dosed at 6mg/kg/day (N=248, 62%) divided twice daily (N=272, 68%). The recommended duration of iron treatment after resolution of anemia and normalized serum ferritin varied widely from 0 to 3 months. For an adolescent with heavy menstrual bleeding and IDA, most respondents recommended ferrous sulfate (N=327, 83%), with dosing based on the number of tablets daily. For IDA refractory to oral treatment, intravenous iron therapy was recommended most frequently, 48% (N=188) using iron sucrose, 17% (N=68) ferric gluconate, and 15% (N=60) low molecular weight iron dextran. Conclusion: The approach to diagnosis and treatment of IDA in childhood was widely variable among responding ASPHO members. Given the lack of an evidence base to guide clinical decision making, further research investigating IDA management is needed. Pediatr Blood Cancer 2015;62:842-846.

Original languageEnglish (US)
Pages (from-to)842-846
Number of pages5
JournalPediatric Blood and Cancer
Volume62
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Iron-Deficiency Anemias
Hematology
Pediatrics
ferrous sulfate
saccharated ferric oxide
Iron
Therapeutics
Surveys and Questionnaires
Blood Cell Count
Ferritins
Dextrans
Routine Diagnostic Tests
Malnutrition
Tablets
Anemia
Molecular Weight
Hemorrhage

Keywords

  • Iron deficiency anemia
  • Iron therapy

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Management of iron deficiency anemia : A survey of pediatric hematology/oncology specialists. / Powers, Jacquelyn M.; Mccavit, Timothy L.; Buchanan, George R.

In: Pediatric Blood and Cancer, Vol. 62, No. 5, 01.05.2015, p. 842-846.

Research output: Contribution to journalArticle

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abstract = "Background: Iron deficiency anemia (IDA) is the most common hematologic condition in children and adolescents in the United States (US). No prior reports have described the management of IDA by a large cohort of pediatric hematology/oncology specialists. Procedure: A 20-question electronic survey that solicited responses to two hypothetical cases of IDA was sent to active members of the American Society of Pediatric Hematology/Oncology (ASPHO) in the US. Results: Of 1,217 recipients, 398 (32.7{\%}) reported regularly treating IDA and completed the survey. In a toddler with nutritional IDA, 15{\%} (N=61) of respondents reported ordering no diagnostic test beyond a complete blood count. Otherwise, wide variability in laboratory testing was reported. For treatment, most respondents would prescribe ferrous sulfate (N=335, 84{\%}) dosed at 6mg/kg/day (N=248, 62{\%}) divided twice daily (N=272, 68{\%}). The recommended duration of iron treatment after resolution of anemia and normalized serum ferritin varied widely from 0 to 3 months. For an adolescent with heavy menstrual bleeding and IDA, most respondents recommended ferrous sulfate (N=327, 83{\%}), with dosing based on the number of tablets daily. For IDA refractory to oral treatment, intravenous iron therapy was recommended most frequently, 48{\%} (N=188) using iron sucrose, 17{\%} (N=68) ferric gluconate, and 15{\%} (N=60) low molecular weight iron dextran. Conclusion: The approach to diagnosis and treatment of IDA in childhood was widely variable among responding ASPHO members. Given the lack of an evidence base to guide clinical decision making, further research investigating IDA management is needed. Pediatr Blood Cancer 2015;62:842-846.",
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