Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia

Background Iron deficiency anemia (IDA) is the most common cause of anemia worldwide. Patients with IDA often present thrombocytosis, but little is known about its degree and prevalence, and its response to iron replacement.Methods We conducted a retrospective review of 76 consecutive patients with...

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Main Authors: Giampaolo Talamo, Oluwagbemiga Oyeleye, Asmita Paudel, Hamnah Tayyab, Muneer Khan, Marcelle G. Meseeha, Ghanshyam Bhatta
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2458358
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author Giampaolo Talamo
Oluwagbemiga Oyeleye
Asmita Paudel
Hamnah Tayyab
Muneer Khan
Marcelle G. Meseeha
Ghanshyam Bhatta
author_facet Giampaolo Talamo
Oluwagbemiga Oyeleye
Asmita Paudel
Hamnah Tayyab
Muneer Khan
Marcelle G. Meseeha
Ghanshyam Bhatta
author_sort Giampaolo Talamo
collection DOAJ
description Background Iron deficiency anemia (IDA) is the most common cause of anemia worldwide. Patients with IDA often present thrombocytosis, but little is known about its degree and prevalence, and its response to iron replacement.Methods We conducted a retrospective review of 76 consecutive patients with anemia secondary only to iron deficiency. Laboratory data were collected both at baseline and at 3 months after either oral or intravenous iron replacement therapy. We defined thrombocytosis as a platelet count >400 × 109/L.Results The median age of the patients was 54 years (range, 22–90 years), and 59 of 76 (78%) patients were females. The replacement therapy consisted of oral iron (n = 13), intravenous iron (n = 33), or both (n = 30). The median Hb and ferritin levels at baseline and at 3 months after the iron replacement were 9.9 g/dL and 18 mg/dL, and 12.4 g/dL (p < 0.0001) and 113 mg/dL (p < 0.0001), respectively. Thrombocytosis before and after the iron administration was present in 17 (22%) and 4 (5%) patients, respectively. Regardless of thrombocytosis, the platelet count decreased in 55 (72%) patients. The median platelet level at baseline and at 3 months after the iron replacement was 299 (95% CI, 276–330) and 265 (95% CI, 245–295) × 109/L (p < 0.0001), respectively.Conclusion Thrombocytosis is found in about one fifth of patients with IDA at baseline, and it is expected to resolve within 3 months of iron replacement therapy in most of them. Iron administration is associated with a decrease of the platelet counts, even in the absence of preexisting thrombocytosis.
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spelling doaj-art-7e9a16a985894998ae93b0ebc85713d92025-08-20T03:48:13ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2458358Platelet levels before and after iron replacement therapy in patients with iron deficiency anemiaGiampaolo Talamo0Oluwagbemiga Oyeleye1Asmita Paudel2Hamnah Tayyab3Muneer Khan4Marcelle G. Meseeha5Ghanshyam Bhatta6Hematology/Oncology, Guthrie Robert Packer Hospital, Sayre, PA, USAInternal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USAInternal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USAInternal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USAHematology/Oncology, Guthrie Robert Packer Hospital, Sayre, PA, USAHematology/Oncology, Guthrie Robert Packer Hospital, Sayre, PA, USAInternal Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USABackground Iron deficiency anemia (IDA) is the most common cause of anemia worldwide. Patients with IDA often present thrombocytosis, but little is known about its degree and prevalence, and its response to iron replacement.Methods We conducted a retrospective review of 76 consecutive patients with anemia secondary only to iron deficiency. Laboratory data were collected both at baseline and at 3 months after either oral or intravenous iron replacement therapy. We defined thrombocytosis as a platelet count >400 × 109/L.Results The median age of the patients was 54 years (range, 22–90 years), and 59 of 76 (78%) patients were females. The replacement therapy consisted of oral iron (n = 13), intravenous iron (n = 33), or both (n = 30). The median Hb and ferritin levels at baseline and at 3 months after the iron replacement were 9.9 g/dL and 18 mg/dL, and 12.4 g/dL (p < 0.0001) and 113 mg/dL (p < 0.0001), respectively. Thrombocytosis before and after the iron administration was present in 17 (22%) and 4 (5%) patients, respectively. Regardless of thrombocytosis, the platelet count decreased in 55 (72%) patients. The median platelet level at baseline and at 3 months after the iron replacement was 299 (95% CI, 276–330) and 265 (95% CI, 245–295) × 109/L (p < 0.0001), respectively.Conclusion Thrombocytosis is found in about one fifth of patients with IDA at baseline, and it is expected to resolve within 3 months of iron replacement therapy in most of them. Iron administration is associated with a decrease of the platelet counts, even in the absence of preexisting thrombocytosis.https://www.tandfonline.com/doi/10.1080/16078454.2025.2458358Iron deficiencymicrocytic anemiathrombocytosisplatelet responseiron replacement therapy
spellingShingle Giampaolo Talamo
Oluwagbemiga Oyeleye
Asmita Paudel
Hamnah Tayyab
Muneer Khan
Marcelle G. Meseeha
Ghanshyam Bhatta
Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
Hematology
Iron deficiency
microcytic anemia
thrombocytosis
platelet response
iron replacement therapy
title Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
title_full Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
title_fullStr Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
title_full_unstemmed Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
title_short Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
title_sort platelet levels before and after iron replacement therapy in patients with iron deficiency anemia
topic Iron deficiency
microcytic anemia
thrombocytosis
platelet response
iron replacement therapy
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2458358
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