Association of iron infusion reactions with ABO blood type

Eur J Haematol. 2022 Nov;109(5):519-525. doi: 10.1111/ejh.13838. Epub 2022 Aug 9.

Abstract

Objectives: We sought to determine risk factors for iv iron infusion-related reactions (IRR), and identify strategies for iron repletion after IRR.

Methods: We conducted a retrospective chart review of patients treated in the classical hematology clinic at Yale Cancer Center (n = 330 consecutive patients) from 2016 to 2021, who received iv ferumoxytol (60.3%), iron sucrose (14.8%), or iron dextran (10.9%).

Results: The iv iron IRR was noted in 58 (17.6%) patients, 62.1% of whom had previously tolerated iv iron. The severity of IRR was mild in 22, moderate in 23, and severe in 11 patients. Most (72.4%) patients who experienced IRR tolerated a subsequent iv iron infusion. On multivariable analysis, a history of non-medication allergies was associated with greater odds of IRR (odds ratio [OR] 2.12, 95% confidence interval (CI): 1.16-3.87, p = .01). No patients with type AB blood, and few with type A blood (n = 6), had IRR; compared to type A or AB together, patients with type B (OR 5.00, 95% CI: 1.56-16.06, p = .007) or type O (OR 3.71, 95% CI: 1.44-9.55, p = .007) blood had greater odds of IRR.

Conclusions: This study highlights a possible association of blood type with iv iron IRR; prospective studies with larger patient numbers are warranted to explore this association.

Keywords: allergy; hypersensitivity reactions; infusion reactions; intravenous iron; iron deficiency anemia.

MeSH terms

  • Anemia, Iron-Deficiency* / diagnosis
  • Anemia, Iron-Deficiency* / drug therapy
  • Anemia, Iron-Deficiency* / epidemiology
  • Dextrans / therapeutic use
  • Ferric Oxide, Saccharated / adverse effects
  • Ferrosoferric Oxide* / adverse effects
  • Humans
  • Iron / adverse effects
  • Prospective Studies
  • Retrospective Studies

Substances

  • Dextrans
  • ferryl iron
  • Iron
  • Ferric Oxide, Saccharated
  • Ferrosoferric Oxide