Anemia - Complications

Effects of Vitamin B12 Deficiencies and Pernicious Anemia

In addition to anemia, vitamin B12 deficiency can cause neurologic damage, which can be irreversible if it continues for long periods without treatment. People with pernicious anemia, which results in an inability to absorb the vitamin, are not only at risk for neurologic damage, but also have a higher risk for stomach cancer and possibly cancer of the throat and mouth.

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Anemia in Patients with Cancer

Anemia is particularly serious in cancer patients. In people with many common cancers, the presence of anemia is associated with a shorter survival time. Anemia may worsen the toxicity of chemotherapy in elderly cancer patients.

Anemia in Patients with Kidney Disease

Anemia is associated with higher mortality rates and possibly heart disease in patients with kidney disease.

Anemia in Patients with Heart Failure

The combination of anemia and heart failure can increase the risk of hospitalization or death by 30 ? 60%. Patients with heart failure whose hemoglobin levels decline do worse than patients with stable levels.

Effects of Excess Iron

Iron overload occurs when there is too much iron in the blood. It can be as serious a problem as iron deficiency. Iron overload is usually caused by:·

Blood transfusions. Patients with certain types of anemia require frequent blood transfusions. These transfusions can cause iron overload. Patients are treated with iron chelation therapy, which uses a drug that binds to iron. Excess iron is then eliminated by the kidneys. The standard drug for iron chelation therapy, deferoxamine (Desferal), is injected intravenously through an infusion pump. The treatment can be difficult for many patients. In 2005, a new drug, deferasirox (Exjade), was approved to treat iron overload due to blood transfusions. It is taken once a day by mouth. Patients dilute the pills in liquid and drink the mixture.
Hemochromatosis. Hemochromatosis is a hereditary condition in which the intestinal tract absorbs too much iron from food. Over time this excess iron leads to damaged organs and joints. To reduce dangerous iron levels, blood is regularly removed from the patient's body. This procedure is called phlebotomy. It is similar to donating blood. Some patients also need iron chelation therapy. Deferoxamine is currently used for iron chelation therapy in patients with hemochromatosis. Researchers are investigating deferasirox for chelation treatment of this genetic condition.