Efficacy and Safety of Intravenous Ferric Derisomaltose for Chemotherapy-Induced Anemia: A Single-Center Retrospective Study in Japan

Introduction Chemotherapy-induced anemia (CIA) is a frequent complication in gynecologic cancers. In this study, we evaluated the effectiveness and safety of ferric derisomaltose (FDI), a high-dose intravenous (IV) iron formulation, for treating patients with CIA. Methods In this retrospective study, we analyzed patients with gynecologic cancers and CIA. A total of 29 patients with hemoglobin (Hb) levels <9.0 g/dL, or who were anticipated to fall below this threshold during chemotherapy, received a single 1,000 mg dose of FDI between 2023 and 2024. As a historical control group, 51 patients treated between 2020 and 2021 who did not receive IV iron were included. The primary outcome was the change in Hb level on day 21. Secondary outcomes included red blood cell (RBC) transfusion rates and the incidence of chemotherapy discontinuation, delay, or dose reduction. Results The baseline Hb levels were 7.6 ± 0.4 g/dL in the FDI group and 7.9 ± 0.4 g/dL in the control group. By day 21, the mean Hb level had increased to 9.4 ± 1.0 g/dL in the FDI group, whereas it declined to 7.4 ± 0.7 g/dL in the control group (p < 0.001). Significantly fewer patients required RBC transfusions in the FDI group than in the control group (two [6.9%] and 17 patients [33.3%], respectively; p = 0.007). Chemotherapy modifications occurred in five patients (17.2%) in the FDI group versus 11 patients (21.6%) in the control group (p = 0.642). Conclusion FDI significantly increased the Hb levels and reduced transfusion requirements in patients with gynecologic cancers and CIA. It was well tolerated and may represent a valuable alternative therapeutic option for managing CIA.