Iron replacement treatment help recover thrombocytosis in anemia patients: Study

A new study published in the journal of Hematology showed that about one-fifth of iron deficiency anemia (IDA) patients have thrombocytosis at baseline, and most of them should recover within 3 months after starting iron replacement treatment.

One-fourth of the world's population suffers from anemia, which contributes 8.8% of the overall illness burden worldwide. The most prevalent cause of anemia in both sexes and across nations is iron deficiency, with women more likely to suffer from it. The lack of iron can also lead to infertility, exhaustion, poor quality of life, restless legs syndrome (RLS), and cognitive decline.

Although thrombocytosis is frequently seen in IDA patients, little is known regarding its severity, frequency, and reaction to iron replacement therapy. Yet, a few case studies have detailed the thrombotic side effects linked to IDA-induced thrombocytosis.

To avoid thrombotic consequences, patients with a high risk of thrombosis must be identified quickly and treated effectively. There is little published data on how iron supplementation influences the thrombocytosis brought on by IDA, despite the fact that iron replacement therapy has been demonstrated to lower platelet counts in this situation.

Since treatment is known to enhance physical condition and quality of life, there is strong evidence to encourage early treatment for all patients with iron deficiency anemia. Thus, Giampaolo Talamo and team conducted this study in order to assess the effects of iron replacement therapy on the platelet levels.

A retrospective analysis of 76 successive patients with anemia solely due to iron deficiency was carried out. Both at baseline and three months following intravenous or oral iron replacement therapy, laboratory results were gathered. Thrombocytosis was described as a platelet count more than 400 × 109/L.

A total of 59 out of 76 patients (78%) were female, and the average age of those receiving treatment was 54 years. Iron replacement treatment included intravenous iron (n = 33), oral iron (n = 13), or both (n = 30). At baseline, the median Hb and ferritin levels were 9.9 g/dL and 18 mg/dL, respectively, and 3 months after the iron replacement, they were 12.4 g/dL and 113 mg/dL.

There were 17 (22%) and 4 (5%) individuals with thrombocytosis prior to and following the iron therapy, respectively. 55 individuals (72%) saw a drop in platelet count regardless of thrombocytosis. At baseline, the median platelet level was 299 × 109/L and at 3 months after the iron replacement, it was 265 × 109/L. Overall, even when there is no underlying thrombocytosis, iron supplementation is linked to a drop in platelet counts.

Source:

Talamo, G., Oyeleye, O., Paudel, A., Tayyab, H., Khan, M., Meseeha, M. G., & Bhatta, G. (2025). Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia. Hematology (Amsterdam, Netherlands), 30(1). https://doi.org/10.1080/16078454.2025.2458358