Iron Replacement to Reduce Anemia During Neoadjuvant Chemotherapy (Iron-RANC)

Inclusion Criteria: Male or female patients > 18 years Patients undergoing neoadjuvant chemotherapy, including radiation and/or immunotherapy, with intent for curative surgical resection for breast, thoracic, gastrointestinal (GI) or genitourinary (GU) malignancies. Anemia defined as Hgb <10.5 g/dL during chemotherapy. Iron storage levels of ferritin <500 ng/mL and iron saturation <35% Ability to understand and willingness to sign a written informed consent and HIPAA consent document Exclusion Criteria: Diagnosis of anemia at the time of cycle 1 day 1 of neoadjuvant chemotherapy, Hgb < 11.0 g/dL, uncontrolled intercurrent illness including, but not limited to, ongoing active infection, symptomatic new/exacerbated congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Prior parenteral iron infusion in the past 4 weeks The use of erythropoietin stimulating agents within 4 weeks unless chronic needs due to CKD Concurrent systemic infection at the time of enrollment. Known hypersensitivity to Iron sucrose Pregnant or breast feeding. Refer to section 4.4 for further detail. Anemia from another established etiology (i.e MDS, Myeloma)