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.