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Cytotoxic Chemotherapy Worsens Iron Deficiency Anaemia among Indian Women with Non - Metastatic Breast Cancer.

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion 2026 Vol.42(1) p. 146-153

Saroja K, Bobby Z, Dubashi B, Toi PC, Thalapalliyil K

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[PURPOSE] Assessment of the effect of cytotoxic chemotherapy on the indices of iron homeostasis to elucidate the aetiology of anaemia in breast cancer.

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APA Saroja K, Bobby Z, et al. (2026). Cytotoxic Chemotherapy Worsens Iron Deficiency Anaemia among Indian Women with Non - Metastatic Breast Cancer.. Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion, 42(1), 146-153. https://doi.org/10.1007/s12288-025-01972-6
MLA Saroja K, et al.. "Cytotoxic Chemotherapy Worsens Iron Deficiency Anaemia among Indian Women with Non - Metastatic Breast Cancer.." Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion, vol. 42, no. 1, 2026, pp. 146-153.
PMID 41522535

Abstract

[PURPOSE] Assessment of the effect of cytotoxic chemotherapy on the indices of iron homeostasis to elucidate the aetiology of anaemia in breast cancer.

[METHODS] Forty-two newly diagnosed breast cancer patients with Hb > 10 g/dL were recruited. Iron indices were estimated before and after neoadjuvant chemotherapy (NACT). Anaemia of chronic disease (ACD) and anaemia of chronic disease + iron deficiency anaemia (IDA) were identified by sTfR, sTfR index, and algorithm by Skikne et al.

[RESULTS] Anaemia was 52% at the presentation time, which increased to 93% at the end of NACT. Among the anaemic breast cancer patients, 75% belonged to the group of ACD + IDA, and only 25% belonged to the group of ACD at the time of presentation. After NACT, the number of patients in the ACD + IDA group significantly increased to 93%, while the members of the ACD group significantly reduced to 7%. Ferritin, Hepcidin, Transferrin, sTfR, and sTfR index increased after NACT.

[CONCLUSION] The primary aetiology of anaemia among Indian breast cancer patients is a combination of ACD and IDA. Indian breast cancer patients were more vulnerable to developing iron deficiency anaemia when compared to anaemia of chronic disease during NACT.