TY - JOUR
T1 - Management of iron deficiency anemia
T2 - A survey of pediatric hematology/oncology specialists
AU - Powers, Jacquelyn M.
AU - Mccavit, Timothy L.
AU - Buchanan, George R.
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - 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.
AB - 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.
KW - Iron deficiency anemia
KW - Iron therapy
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U2 - 10.1002/pbc.25433
DO - 10.1002/pbc.25433
M3 - Article
C2 - 25663613
AN - SCOPUS:84925355682
SN - 1545-5009
VL - 62
SP - 842
EP - 846
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 5
ER -