{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:10:49Z","timestamp":1790964649641,"version":"4.1.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100030779","name":"ZERIA Pharmaceutical","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100030779","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Clin Oncol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anemia is one of the common complications in patients with cancer, particularly among those undergoing systemic chemotherapy. Current guidelines for chemotherapy-induced anemia (CIA) recommend anemia evaluation and treatment, including assessing iron deficiency. However, actual pre- and post- chemotherapy clinical practices in Japan remain unclear. This retrospective observational study investigated real-world CIA management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this descriptive study, we included patients with solid tumors who underwent antineoplastic therapy between January 2015 and March 2025. Baseline and follow-up hemoglobin (Hb) levels, transferrin saturation (TSAT), and serum ferritin levels were assessed. We also evaluated the anemia treatment status before and after chemotherapy, and changes in Hb levels following iron supplementation before chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 75,603 patients were included. At baseline, 55.1% of patients had Hb levels below the lower limit of normal, and 11% presented with moderate-to-severe anemia (Hb\u2009&lt; 10\u00a0g\/dL). Iron parameters were measured in\u2009&lt;\u200910% of patients. Among them, functional iron deficiency (TSAT\u2009&lt;\u200950% with ferritin\u2009\u2265\u200930 and\u2009\u2264\u2009500\u00a0ng\/mL) was the predominant finding, increasing from 54.8% to 61.6% after chemotherapy initiation. Nevertheless, intravenous iron therapy was prescribed in\u2009&lt;\u20093% of patients. An increase in Hb levels was observed in certain patients who prescribed intravenous iron 4\u20138\u00a0weeks prior to chemotherapy, including those with initially low Hb levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that anemia is highly prevalent in patients with cancer and worsens following chemotherapy. Additionally, iron parameters were rarely measured, and functional iron deficiency was frequently observed among the tested subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-03057-4","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:25:54Z","timestamp":1780410354000},"page":"1408-1417","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of iron deficiency anemia and the role of intravenous iron supplementation in patients undergoing cancer chemotherapy: a real-world retrospective study in Japan"],"prefix":"10.1007","volume":"31","author":[{"given":"Miyako","family":"Kosugi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Takezawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3863-8184","authenticated-orcid":false,"given":"Shun","family":"Shiota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Inokuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Takaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"3057_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.2147\/CLEP.S89480","volume":"8","author":"H Xu","year":"2016","unstructured":"Xu H, Xu L, Page JH et al (2016) Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010\u20132013. Clin Epidemiol 8:61\u201371. https:\/\/doi.org\/10.2147\/CLEP.S89480","journal-title":"Clin Epidemiol"},{"key":"3057_CR2","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1093\/jnci\/91.19.1616","volume":"91","author":"JE Groopman","year":"1999","unstructured":"Groopman JE, Itri LM (1999) Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 91:1616\u20131634. https:\/\/doi.org\/10.1093\/jnci\/91.19.1616","journal-title":"J Natl Cancer Inst"},{"key":"3057_CR3","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1016\/j.ejca.2004.06.019","volume":"40","author":"H Ludwig","year":"2004","unstructured":"Ludwig H, Van Belle S, Barrett-Lee P et al (2004) The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer 40:2293\u20132306. https:\/\/doi.org\/10.1016\/j.ejca.2004.06.019","journal-title":"Eur J Cancer"},{"issue":"Pt 2","key":"3057_CR4","doi-asserted-by":"publisher","first-page":"2416","DOI":"10.1016\/j.clinthera.2009.11.020","volume":"31","author":"Y Wu","year":"2009","unstructured":"Wu Y, Aravind S, Ranganathan G et al (2009) Anemia and thrombocytopenia in patients undergoing chemotherapy for solid tumors: a descriptive study of a large outpatient oncology practice database, 2000\u20132007. Clin Ther 31(Pt 2):2416\u20132432. https:\/\/doi.org\/10.1016\/j.clinthera.2009.11.020","journal-title":"Clin Ther"},{"key":"3057_CR5","doi-asserted-by":"publisher","first-page":"628","DOI":"10.6004\/jnccn.2012.0064","volume":"10","author":"GM Rodgers 3rd","year":"2012","unstructured":"Rodgers GM 3rd, Becker PS, Blinder M et al (2012) Cancer- and chemotherapy-induced anemia. J Natl Compr Canc Netw 10:628\u2013653. https:\/\/doi.org\/10.6004\/jnccn.2012.0064","journal-title":"J Natl Compr Canc Netw"},{"key":"3057_CR6","doi-asserted-by":"publisher","first-page":"593","DOI":"10.2147\/JEP.S262349","volume":"13","author":"C Madeddu","year":"2021","unstructured":"Madeddu C, Neri M, Sanna E et al (2021) Experimental drugs for chemotherapy- and cancer-related anemia. J Exp Pharmacol 13:593\u2013611. https:\/\/doi.org\/10.2147\/JEP.S262349","journal-title":"J Exp Pharmacol"},{"issue":"Suppl 7","key":"3057_CR7","doi-asserted-by":"publisher","first-page":"vii167","DOI":"10.1093\/annonc\/mdq284","volume":"21","author":"M Dicato","year":"2010","unstructured":"Dicato M, Plawny L, Diederich M (2010) Anemia in cancer. Ann Oncol 21(Suppl 7):vii167\u2013vii172. https:\/\/doi.org\/10.1093\/annonc\/mdq284","journal-title":"Ann Oncol"},{"key":"3057_CR8","doi-asserted-by":"publisher","first-page":"1954","DOI":"10.1093\/annonc\/mds112","volume":"23","author":"M Aapro","year":"2012","unstructured":"Aapro M, \u00d6sterborg A, Gasc\u00f3n P et al (2012) Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron. Ann Oncol 23:1954\u20131962. https:\/\/doi.org\/10.1093\/annonc\/mds112","journal-title":"Ann Oncol"},{"key":"3057_CR9","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.3945\/ajcn.114.103366","volume":"102","author":"L Peyrin-Biroulet","year":"2015","unstructured":"Peyrin-Biroulet L, Williet N, Cacoub P (2015) Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review. Am J Clin Nutr 102:1585\u20131594. https:\/\/doi.org\/10.3945\/ajcn.114.103366","journal-title":"Am J Clin Nutr"},{"key":"3057_CR10","doi-asserted-by":"publisher","unstructured":"Cancado RD, Leite LAC, Mu\u00f1oz M (2025) Defining global thresholds for serum ferritin: A challenging mission in establishing the iron deficiency diagnosis in this era of striving for health equity. Diagnostics (Basel) 15:. https:\/\/doi.org\/10.3390\/diagnostics15030289","DOI":"10.3390\/diagnostics15030289"},{"key":"3057_CR11","volume-title":"Discretionary guide for iron deficiency anemia [Japanese edition]","author":"The Japanese BioIron Society","year":"2024","unstructured":"The Japanese BioIron Society (2024) Discretionary guide for iron deficiency anemia [Japanese edition]. Fuji Medical Publishers, Japan"},{"key":"3057_CR12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/bs.acc.2016.03.002","volume":"75","author":"ME Elsayed","year":"2016","unstructured":"Elsayed ME, Sharif MU, Stack AG (2016) Transferrin saturation: a body iron biomarker. Adv Clin Chem 75:71\u201397. https:\/\/doi.org\/10.1016\/bs.acc.2016.03.002","journal-title":"Adv Clin Chem"},{"key":"3057_CR13","unstructured":"World Health Organization (2020) WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. https:\/\/pubmed.ncbi.nlm.nih.gov\/33909381\/. Accessed 24 Oct 2025"},{"key":"3057_CR14","doi-asserted-by":"publisher","first-page":"436","DOI":"10.6004\/jnccn.2022.0026","volume":"20","author":"EA Griffiths","year":"2022","unstructured":"Griffiths EA, Roy V, Alwan L et al (2022) NCCN guidelines\u00ae insights: hematopoietic growth factors, version 1.2022. J Natl Compr Canc Netw 20:436\u2013442. https:\/\/doi.org\/10.6004\/jnccn.2022.0026","journal-title":"J Natl Compr Canc Netw"},{"key":"3057_CR15","doi-asserted-by":"publisher","unstructured":"Aapro M, Beguin Y, Bokemeyer C, et al (2018) Management of anaemia and iron deficiency in patients with cancer: ESMO Clinical Practice Guidelines. Ann Oncol 29:iv271. https:\/\/doi.org\/10.1093\/annonc\/mdy323","DOI":"10.1093\/annonc\/mdy323"},{"key":"3057_CR16","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1002\/ajh.23628","volume":"89","author":"JA Gilreath","year":"2014","unstructured":"Gilreath JA, Stenehjem DD, Rodgers GM (2014) Diagnosis and treatment of cancer-related anemia: diagnosis and treatment of cancer-related anemia. Am J Hematol 89:203\u2013212. https:\/\/doi.org\/10.1002\/ajh.23628","journal-title":"Am J Hematol"},{"key":"3057_CR17","doi-asserted-by":"publisher","DOI":"10.1007\/s44313-024-00030-w","volume":"59","author":"JS Koh","year":"2024","unstructured":"Koh JS, Song I-C (2024) Functional iron deficiency anemia in patients with cancer. Blood Res 59:26. https:\/\/doi.org\/10.1007\/s44313-024-00030-w","journal-title":"Blood Res"},{"key":"3057_CR18","unstructured":"National Comprehensive Cancer Network (2025) NCCN guidelines, Hematopoietic growth factors, version 1. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/growthfactors.pdf"},{"key":"3057_CR19","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1093\/annonc\/mds338","volume":"24","author":"T Steinmetz","year":"2013","unstructured":"Steinmetz T, Tschechne B, Harlin O et al (2013) Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia. Ann Oncol 24:475\u2013482. https:\/\/doi.org\/10.1093\/annonc\/mds338","journal-title":"Ann Oncol"},{"key":"3057_CR20","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s00520-015-2728-3","volume":"24","author":"A Toledano","year":"2016","unstructured":"Toledano A, Luporsi E, Morere JF et al (2016) Clinical use of ferric carboxymaltose in patients with solid tumours or haematological malignancies in France. Support Care Cancer 24:67\u201375. https:\/\/doi.org\/10.1007\/s00520-015-2728-3","journal-title":"Support Care Cancer"},{"key":"3057_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2019.102837","volume":"145","author":"H Abdel-Razeq","year":"2020","unstructured":"Abdel-Razeq H, Hashem H (2020) Recent update in the pathogenesis and treatment of chemotherapy and cancer induced anemia. Crit Rev Oncol Hematol 145:102837. https:\/\/doi.org\/10.1016\/j.critrevonc.2019.102837","journal-title":"Crit Rev Oncol Hematol"},{"key":"3057_CR22","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11144156","volume":"11","author":"S Buchrits","year":"2022","unstructured":"Buchrits S, Itzhaki O, Avni T et al (2022) Intravenous iron supplementation for the treatment of chemotherapy-induced anemia: a systematic review and meta-analysis of randomized controlled trials. J Clin Med 11:4156. https:\/\/doi.org\/10.3390\/jcm11144156","journal-title":"J Clin Med"},{"key":"3057_CR23","doi-asserted-by":"publisher","first-page":"58","DOI":"10.37737\/ace.24009","volume":"6","author":"Y Okumura","year":"2024","unstructured":"Okumura Y, Fujiwara T, Tokumasu H et al (2024) A new electronic medical record database linked to claims data and discharge abstract data (the RWD database) in Japan: study design and profile. Ann Clin Epidemiol 6:58\u201364. https:\/\/doi.org\/10.37737\/ace.24009","journal-title":"Ann Clin Epidemiol"},{"key":"3057_CR24","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1007\/s00520-014-2189-0","volume":"22","author":"H Ludwig","year":"2014","unstructured":"Ludwig H, Aapro M, Bokemeyer C et al (2014) A European patient record study on diagnosis and treatment of chemotherapy-induced anaemia. Support Care Cancer 22:2197\u20132206. https:\/\/doi.org\/10.1007\/s00520-014-2189-0","journal-title":"Support Care Cancer"},{"key":"3057_CR25","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s00520-023-08267-4","volume":"32","author":"H Link","year":"2024","unstructured":"Link H, Kerkmann M, Holtmann L et al (2024) Anemia diagnosis and therapy in malignant diseases: implementation of guidelines-a representative study. Support Care Cancer 32:113. https:\/\/doi.org\/10.1007\/s00520-023-08267-4","journal-title":"Support Care Cancer"},{"key":"3057_CR26","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/s0093-7754(01)90206-4","volume":"28","author":"H Ludwig","year":"2001","unstructured":"Ludwig H, Strasser K (2001) Symptomatology of anemia. Semin Oncol 28:7\u201314. https:\/\/doi.org\/10.1016\/s0093-7754(01)90206-4","journal-title":"Semin Oncol"},{"issue":"Suppl 7A","key":"3057_CR27","doi-asserted-by":"publisher","first-page":"11S","DOI":"10.1016\/j.amjmed.2003.12.008","volume":"116","author":"K Knight","year":"2004","unstructured":"Knight K, Wade S, Balducci L (2004) Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med 116(Suppl 7A):11S-26S. https:\/\/doi.org\/10.1016\/j.amjmed.2003.12.008","journal-title":"Am J Med"},{"key":"3057_CR28","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1093\/oncolo\/oyac005","volume":"27","author":"C Gluszak","year":"2022","unstructured":"Gluszak C, de Vries-Brilland M, Seegers V et al (2022) Impact of iron-deficiency management on quality of life in patients with cancer: a prospective cohort study (CAMARA study). Oncologist 27:328\u2013333. https:\/\/doi.org\/10.1093\/oncolo\/oyac005","journal-title":"Oncologist"},{"key":"3057_CR29","first-page":"426","volume":"41","author":"I Yoshino","year":"2014","unstructured":"Yoshino I (2014) Treatment of cancer chemotherapy-associated anemia in Japan - conditions and issues. Gan To Kagaku Ryoho 41:426\u2013431","journal-title":"Gan To Kagaku Ryoho"},{"key":"3057_CR30","doi-asserted-by":"publisher","first-page":"2750","DOI":"10.1111\/trf.13780","volume":"56","author":"T Akita","year":"2016","unstructured":"Akita T, Tanaka J, Ohisa M et al (2016) Predicting future blood supply and demand in Japan with a Markov model: application to the sex- and age-specific probability of blood donation. Transfusion 56:2750\u20132759. https:\/\/doi.org\/10.1111\/trf.13780","journal-title":"Transfusion"},{"key":"3057_CR31","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s10147-014-0677-3","volume":"19","author":"A Tanaka","year":"2014","unstructured":"Tanaka A, Yoshino I, Makino S et al (2014) Questionnaire-based survey on chemotherapy-induced anemia. Int J Clin Oncol 19:411\u2013420. https:\/\/doi.org\/10.1007\/s10147-014-0677-3","journal-title":"Int J Clin Oncol"},{"key":"3057_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.6004\/jnccn.2023.7108","volume":"22","author":"DH Hufnagel","year":"2024","unstructured":"Hufnagel DH, Bos LM, Brown AJ et al (2024) Compliance with NCCN guidelines for evaluation and treatment of anemia among patients with solid tumors. J Natl Compr Canc Netw 22:1\u20137. https:\/\/doi.org\/10.6004\/jnccn.2023.7108","journal-title":"J Natl Compr Canc Netw"},{"key":"3057_CR33","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1182\/blood-2018-05-815944","volume":"133","author":"C Camaschella","year":"2019","unstructured":"Camaschella C (2019) Iron deficiency. Blood 133:30\u201339. https:\/\/doi.org\/10.1182\/blood-2018-05-815944","journal-title":"Blood"},{"key":"3057_CR34","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s12185-024-03801-4","volume":"120","author":"M Kosugi","year":"2024","unstructured":"Kosugi M, Takezawa R, Shiota S et al (2024) Clinical management of iron deficiency anemia in Japan: iron prescription patterns, treatment effectiveness, and assessments. Int J Hematol 120:167\u2013178. https:\/\/doi.org\/10.1007\/s12185-024-03801-4","journal-title":"Int J Hematol"},{"key":"3057_CR35","doi-asserted-by":"publisher","first-page":"422","DOI":"10.2450\/2017.0113-17","volume":"15","author":"M Mu\u00f1oz","year":"2017","unstructured":"Mu\u00f1oz M, G\u00f3mez-Ram\u00edrez S, Besser M et al (2017) Current misconceptions in diagnosis and management of iron deficiency. Blood Transfus 15:422\u2013437. https:\/\/doi.org\/10.2450\/2017.0113-17","journal-title":"Blood Transfus"},{"key":"3057_CR36","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2686-2","volume":"16","author":"C Gemici","year":"2016","unstructured":"Gemici C, Yetmen O, Yaprak G et al (2016) Is there any role of intravenous iron for the treatment of anemia in cancer? BMC Cancer 16:661. https:\/\/doi.org\/10.1186\/s12885-016-2686-2","journal-title":"BMC Cancer"}],"container-title":["International Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-026-03057-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10147-026-03057-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10147-026-03057-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:19:29Z","timestamp":1782407969000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10147-026-03057-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":36,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["3057"],"URL":"https:\/\/doi.org\/10.1007\/s10147-026-03057-4","relation":{},"ISSN":["1341-9625","1437-7772"],"issn-type":[{"value":"1341-9625","type":"print"},{"value":"1437-7772","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"assertion":[{"value":"11 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was funded by Zeria Pharmaceutical Co., Ltd. M.K., R.T., and S.S. are employees of Zeria Pharmaceutical Co., Ltd. S.I. and H.T. are employees of JMDC Inc., who assisted with the study design, analyses, and reporting under a contract from Zeria Pharmaceutical Co., Ltd. M.Y. received an honorarium from Zeria Pharmaceutical Co., Ltd. outside the submitted work; received research funding and honorarium from Eisai Co., Ltd.; and received an honorarium from ONO Pharmaceutical Co., Ltd.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}