Bloodless medicine, iron deficiency, and ASCO reflections

Thursday, June 27, 2019

Episode 24:

David H. Henry, MD, host of Blood & Cancer, is on location at the 2019 annual meeting of the American Society of Clinical Oncology in this podcast. Dr. Henry speaks with one of his own residents, Ronak Mistry, DO, about recent research among “bloodless medicine” patients, iron deficiency, and the ASCO experience.

Plus, in Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about what happens when patients do their own literature search for treatment options.

Show notes

By Emily Bryer, DO, resident in the department of internal medicine, University of Pennsylvania, Philadelphia

  • “Bloodless medicine” patients demonstrated superior outcomes following cardiovascular surgery when their hemoglobin was optimized to a higher level.
  • Iron deficiency is defined as transferrin saturation less than 20 with concurrent ferritin 100-300 or ferritin less than 100.
  • Intravenous iron repletion is superior to oral iron repletion among patients with heart failure.
  • Iron repletion in heart failure correlates with improved functional status.
  • Iron deficiency anemia in heart failure goes underrecognized and undertreated.

Additional reading

Iron supplementation, response in iron-deficiency anemia: Analysis of five trials. Am J Med. 2017 Aug;130(8):991.e1-991.e8.

Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion. 2014 Oct;54(10 Pt 2):2668-77.

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Ilana Yurkiewicz on Twitter: @ilanayurkiewicz

Podcast Participants

David Henry, MD
David Henry, MD, FACP, is a clinical professor of medicine at the University of Pennsylvania and vice chairman of the department of medicine at Pennsylvania Hospital in Philadelphia. He received his bachelor’s degree from Princeton University and his MD from the University of Pennsylvania, then completed his internship, residency, and fellowship at the Hospital of the University of Pennsylvania. After 2 years as an attending in the U.S. Air Force, he was drawn to practicing as a hem-onc because of the close patient contact and interaction, and his belief that, win or lose with each patient, one can always make a difference in their care and lives. Follow Dr. Henry on Twitter: @davidhenrymd. Dr. Henry reported being on the advisory board for Amgen, AMAG Pharmaceuticals, and Pharmacosmos. He reported institutional funding from the National Institutes of Health and FibroGen.
Ilana Yurkiewicz, MD
Ilana Yurkiewicz, MD, is a fellow in hematology and oncology at Stanford University, where she also completed her internal medicine residency. Dr. Yurkiewicz holds an MD from Harvard Medical School and a BS from Yale University. She went into hematology and oncology because of the high-stakes decision-making, meaningful relationships with patients, and opportunity to help people through some of the toughest challenges of their lives. Dr. Yurkiewicz is also a medical journalist. She is a former AAAS Mass Media Fellow and Scientific American blog columnist, and her writing has appeared in numerous media outlets including Hematology News, where she writes the monthly column Hard Questions. Dr. Yurkiewicz is on Twitter: @ilanayurkiewicz. Dr. Yurkiewicz has no relevant conflicts of interest.