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

## TL;DR

This study shows that bevacizumab therapy reduces blood transfusions and improves iron levels in patients with hereditary hemorrhagic telangiectasia.

## Contribution

The study provides evidence that IV bevacizumab improves iron parameters and reduces transfusion needs in HHT patients.

## Key findings

- Bevacizumab therapy reduced erythrocyte transfusion requirements from 6 to 0 units.
- IV iron dose requirements decreased from 5000 mg to 2000 mg after bevacizumab treatment.
- Treated patients had higher hemoglobin and ferritin levels compared to untreated patients.

## Abstract

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.