***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate the safety and efficacy of intravenous ( IV ) sodium ferric gluconate complex ( FG ) , oral ferrous sulfate , or no iron to increase hemoglobin ( Hb ) in anemic cancer patients receiving chemotherapy and epoetin alfa .  PATIENTS AND METHODS In this open-label , multicenter trial , 187 patients with chemotherapy-related anemia ( Hb < 11 g/dl ; serum ferritin > or = 100 ng/ml or transferrin saturation > or = 15 % ) scheduled to receive chemotherapy and epoetin alfa ( 40,000 U subcutaneously weekly ) were r and omized to 8 weeks of 125 mg of IV FG weekly , 325 mg of oral ferrous sulfate three times daily , or no iron . The primary outcome was a change in Hb from baseline to endpoint , first whole-blood or red blood cell transfusion , or study withdrawal . RESULTS One hundred twenty-nine patients were evaluable for efficacy ( FG , n = 41 ; oral iron , n = 44 ; no iron , n = 44 ) . Mean increase in Hb was 2.4 g/dl ( 95 % confidence interval [ CI ] , 2.1 - 2.7 ) for FG ( p = .0092 vs. oral iron ; p = .0044 vs. no iron ) , 1.6 g/dl ( 95 % CI , 1.1 - 2.1 ) for oral iron ( p = .7695 vs. no iron ) , and 1.5 g/dl ( 95 % CI , 1.1 - 1.9 ) for no iron . Hb response ( increase > or = 2 g/dl ) was 73 % for FG ( p = .0099 vs. oral iron ; p = .0029 vs. no iron ) , 46 % for oral iron ( p = .6687 vs. no iron ) , and 41 % for no iron . FG was well tolerated . CONCLUSION For cancer patients with chemotherapy-related anemia receiving epoetin alfa , FG produces a significantly greater increase in Hb and Hb response compared with oral iron or no iron , supporting more aggressive treatment with IV iron supplementation for these patients Hepatic sinusoidal obstruction syndrome ( SOS ) is a serious complication in hematopoietic stem cell transplant ( HSCT ) recipients . To determine the impact of pretransplantation hyperferritinemia on the risk of SOS after HSC transplantation , we retrospectively studied 427 HSCT recipients ( 179 autologous and 248 allogeneic ) .  Serum ferritin levels were measured before transplantation . Patients with and without a diagnosis of SOS were compared regarding demographics ; underlying disease ; transplant characteristics ; receipt of imatinib , busulfan , total body irradiation , gemtuzumab , vancomycin , acyclovir , or methotrexate ; and baseline serum ferritin . Univariate and multivariate ( stepwise logistic regression ) analyses were performed . SOS was diagnosed in 88 patients ( 21 % ) at a median of 10 days ( range , 2 - 29 days ) after transplantation . By multivariate analysis , allogeneic HSC transplantation ( odds ratio [ OR ] = 8.25 ; 95 % confidence interval [ 95 % CI ] , 3.31 - 20.57 ) , receipt of imatinib ( OR = 2.60 ; 95 % CI , 1.16 - 5.84 ) , receipt of busulfan ( OR = 2.18 ; 95 % CI , 1.25 - 3.80 ) , and ferritin serum level higher than 1000 ng/dL ( OR = 1.78 ; 95 % CI , 1.02 - 3.08 ) were risk factors for SOS . A ferritin serum level higher than 1000 ng/dL in the pretransplantation period is an independent risk factor for SOS . The results suggest the need for prospect i ve studies addressing the use of iron chelation in the pretransplantation period Ninety one patients between the ages of 17 and 58 years undergoing histocompatible allogeneic transplants from sibling donors were entered into a double-blind r and omised trial to evaluate the effect of human erythropoietin ( rhu EPO ) at a dose of 300 units per kg/day given thrice weekly by intravenous injection on erythropoiesis and on erythrocyte and platelet transfusion requirements . Dose was ceased when the haemoglobin exceeded 12g/dL and recommenced if the haemoglobin fell below 12 g/dL , at 150 units/kg/day . If the haemoglobin exceeded 12 g/dL on a further occasion , the dose of rhu EPO was not given . Patients received two units of erythrocytes when the haemoglobin dropped below 8.5g/dL and received platelet transfusions when the count dropped below 20 x 10(9)/L. Univariate analysis revealed a significantly higher reticulocyte count , haemoglobin concentration and bone marrow erythropoiesis after day 14 in the group receiving rhu EPO but this was not reflected in decreased erythrocyte transfusion ( 7 + /- 5 in controls versus 6 + /- 5 in rhu EPO group ) or in platelet transfusions ( 11 + /- 7 in controls versus 11 + /- 9 in rhu EPO group ) . Hospitalisation in each group was the same ( 29 + /- 8 in the control group and 28 + /- 8 in the rhu EPO group ) . However , in the multivariate analysis , the administration of rhu EPO was associated with an 18 % reduction in erythrocyte transfusion requirement when other variables were taken into account . No side-effects due to rhu EPO were detected in this study . ( ABSTRACT TRUNCATED AT 250 WORDS Cancer-related anaemia is associated with a wide spectrum of symptoms that can negatively affect quality of life . Because epoetin alfa has demonstrated efficacy in correcting cancer-related anaemia , the impact of this treatment on quality of life was evaluated in a multinational , r and omised , double-blind , placebo-controlled trial in 375 anaemic cancer patients receiving non-platinum-based chemotherapy .  The cancer-specific measures of quality of life included the general scale ( FACT-G Total ) and fatigue subscale ( FACT-An Fatigue subscale ) of the Functional Assessment of Cancer Therapy-Anaemia and the Cancer Linear Analogue Scales measuring energy , ability to do daily activities , and overall quality of life . These measures were also used to examine the relationship between haemoglobin levels and quality of life . Both univariate and multiple linear regression analyses of quality of life data were performed . Results of the univariate analysis have been reported previously . The a priori-planned multiple linear regression analysis , which accounted for the effects of disease progression and several other possibly confounding variables on quality of life , showed a significant advantage for epoetin alfa over placebo for the five scales ( all , P<0.05 ) , and confirmed the results of the univariate analysis . For cancer-specific measures , significant correlations were demonstrated between baseline haemoglobin and quality of life ( r , range : 0.14–0.26 , all P<0.05 ) and between change in haemoglobin and change in quality of life ( r , range : 0.26–0.34 , all P<0.01 ) . These findings provide evidence that increasing haemoglobin levels by epoetin alfa administration can significantly improve cancer patients ' quality of life We conducted a prospect i ve r and omized trial to assess hemoglobin ( Hb ) response to recombinant human erythropoietin ( rhEPO ) therapy  after hematopoietic cell transplantation ( HCT ) . Patients ( N = 131 ) were r and omized ( 1:1 ) between no treatment ( control  arm ) or erythropoietin at 500 U/kg per week ( EPO arm ) . Patients were also stratified into 3 cohorts : patients undergoing myeloablative HCT with rhEPO to start on day (D)28 , patients given nonmyeloablative HCT ( NMHCT ) with rhEPO to start on D28 , and patients also given NMHCT but with rhEPO to start on D0 . The proportion of complete correctors ( ie , Hb ≥13 g/dL ) before D126 posttransplant was 8.1 % in the control arm ( median not reached ) and 63.1 % in the EPO arm ( median , 90 days ) ( P < .001 ) . Hb levels were higher and transfusion requirements decreased ( P < .001 ) in the EPO arm , but not during the first month in the nonmyeloablative cohort starting rhEPO on D0 . There was no difference in rates of thromboembolic events or other complications between the 2 arms . This is the first r and omized trial to demonstrate that rhEPO therapy hastens erythroid recovery and decreases transfusion requirements when started one month after allogeneic HCT . There was no benefit to start rhEPO earlier after NMHCT For the majority of patients with iron deficiency anemia ( IDA ) , a full course of intravenous ( IV ) iron is 1 g. Most IV irons require 5–10 administrations of 100–300 mg . We have successfully employed 1 g low molecular weight iron dextran over 1 hr . For further convenience for patients and physicians , we explored the administration of 1.02 g of ferumoxytol over 15 min instead of the approved 2 × 510 mg injections . Sixty patients with IDA , ( hemoglobin < 11 g/dL , transferrin saturation [ TSAT ] ≤20 % , and ferritin < 100 ng/mL ) with an inadequate response or intolerance to oral iron , received 1020 mg ferumoxytol over 15 min . Vital signs were measured for 1 hr . Adverse events ( AEs ) were collected via telephone at 1 , 2 , and 7 days . Follow‐up visits occurred at 4 and 8 weeks for efficacy assessment s. The primary endpoint was safety and tolerability . Secondary efficacy endpoints included mean change in hemoglobin , TSAT , and red cell distribution width . No serious adverse events ( SAEs ) occurred . Fifty‐eight patients received the planned dose . Twenty‐six out of sixty ( 43.3 % ) patients reported AEs of which 13 were mild and transient during infusion . All resolved within minutes . Fourteen patients reported self‐limited arthralgias , myalgias , and /or headache within 24–48 hr . At Baseline , the mean hemoglobin was 9.4 g/dL. The mean increments at Week 4 and 8 were 2.1 and 2.6 g/dL , respectively . Ferumoxytol , administered as 1.02 g infusion over 15 min was well tolerated with no SAEs and demonstrated excellent efficacy . If corroborated in future studies this represents an improved method of treating IDA . Am . J. Heamtol . 88:944–947 , 2013 . © 2013 Wiley Periodicals , We have used recombinant human erythropoietin ( rHuEPO ) in a phase I/II clinical trial to evaluate its ability to reverse refractory anemia in hematologic disorders .  rHuEPO was administered subcutaneously 5 days per week at escalating doses ( 50 to 150 U/kg per day ) . The aim of treatment was a hemoglobin ( Hb ) level greater than or equal to 10 g/dL without blood transfusion . Of 25 patients treated , 17 were evaluable , most of them with a regular need for transfusion . Eight of these had lymphoproliferative disorders ( three cases of malignant lymphoma and five of monoclonal gammopathy ) and were exposed to cytotoxic therapy .  The other nine patients had hematopoietic stem cell disorders ( four cases of myelodysplastic syndrome , three of idiopathic myelofibrosis , and two of chronic myelogenous leukemia ) . All patients with lymphoproliferative disorder had serum EPO levels inappropriately low for the degree of anemia , while patients with stem cell disorder showed variable values . Erythroid marrow activity was inadequate in all cases . Seven of eight patients with lymphoproliferative disorder responded to treatment maintaining Hb above 10 g/dL without transfusion . The median dose of rHuEPO required for correction of anemia was 75 U/kg . In four cases response was maintained with 50 U/kg , three times per week . There was no complete response among patients with hematopoietic stem cell disorder , although transfusion requirement was eliminated or reduced in four cases . Four patients developed functional iron deficiency during rHuEPO treatment and required iron supplementation to obtain response . Aggravation of splenomegaly was observed in two cases of myeloproliferative disorder . We conclude that : ( 1 ) subcutaneous administration of rHuEPO can be effective and safe in patients with lymphoproliferative disorder exposed to chemotherapy and showing inappropriate EPO response to anemia ; ( 2 ) this is less likely in hematopoietic stem cell disorders , although favorable responses may be observed in occasional patients ; and ( 3 ) functional iron deficiency as a cause of nonresponse to rHuEPO is frequent also in nonrenal anemia Pre‐ clinical studies have demonstrated 
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Nevertheless , the more robust and intriguing of these data suggest that the ESA 's administration at an appropriate time after the infusion of stem cells may be effective both in autologous and allogeneic HSCTs .