The Effect of Bevacizumab Therapy on Reducing Erythrocyte Transfusion Requirements and Preventing Iron Deficiency in Patients With Hereditary Hemorrhagic Telangiectasia.

OBJECTIVE

This multicenter retrospective cohort study aimed to evaluate the association between intravenous (IV) bevacizumab therapy and iron-related parameters and transfusion burden in patients with hereditary hemorrhagic telangiectasia (HHT) in Turkey.

METHODS

Thirty-five genetically or clinically confirmed HHT patients from tertiary centers were included. Patients receiving IV bevacizumab (n=15) were compared with those without bevacizumab exposure (n=20). Longitudinal hematologic parameters, annual IV iron dose, erythrocyte suspension (ES) transfusion volume, and bleeding frequency were recorded. In the bevacizumab group, pre- and post-treatment values were compared.

RESULTS

Before treatment, patients who subsequently received bevacizumab had higher ES transfusion requirements than untreated patients (median 6 vs. 2 units; p=0.029). After bevacizumab therapy, IV iron requirement decreased (median 5000 mg to 2000 mg; p=0.005) and ES transfusion burden declined (median 6 to 0 units; p=0.002). Compared with the non-bevacizumab group, treated patients had higher final hemoglobin (p=0.042) and ferritin levels (p=0.048), while transferrin saturation was higher in the untreated group (p=0.047).

CONCLUSION

In this multicenter retrospective cohort, IV bevacizumab therapy was associated with improved iron parameters and reduced transfusion requirements in patients with HHT-related bleeding.