Published on June 23, 2016
From our MPN Ask the Expert series, Patient Power viewer, Jane, asks a question about using iron supplements for MPN patients who are anemic due to iron deficiency. Dr. John Mascarenhas of Mount Sinai School of Medicine responds with a two-part answer: one for polycythemia vera (PV) patients and another for myelofibrosis (MF) patients.
The Ask the Expert series is sponsored through an educational grant to the Patient Empowerment Network from Incyte Corporation.
Transcript | Is Iron Supplementation Appropriate for Someone With an MPN Who Has Iron-Deficient Anemia?
Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
Here's a question we got in from Jane. Jane wants to know about iron supplementation, iron infusions. Are they appropriate treatment for people who are iron-deficient anemic with an MPN?
So that's a great question. It often comes up. It depends. So, for example, in the setting of polycythemia vera, particularly in patients who are getting therapeutic phlebotomy and are essentially being induced into an iron-deficient state. That is on purpose. One would not want to provide either oral or IV iron, because that would defeat the purpose and increase the hematocrit perhaps putting the patient at risk for thrombotic complications. So in the setting PV, it is not recommended to take iron supplementation. That can sometimes happen.
The patient would see the primary doctor. They would be shown to be iron deficient and with good intention given iron supplementation. So that should be discussed with the hematologist. The patient should be aware of that. Outside of PV, in myelofibrosis, for example, where anemia can be a significant complication of the disease, it's typically not due to iron deficiency. But that can be checked with laboratory iron studies that can then document it. If patients are actually iron deficient, two things need to be done. One—one must figure out why that patient is iron deficient, so for example, is it gastrointestinal bleeding? There may be another issue that could be overlooked and then two; they should be supplemented with iron, whether it's oral or IV iron.
But, in general, unfortunately it's not as iron as iron is a fix to anemia for most patients. I wish it was, but that's usually not the primary reason for people to have it.
You need to look at the specific situation.