Purpose. The incidence and severity of prechemotherapy anemia and chemotherapy-induced anemia experienced by women treated with adjuvant doxorubicin and cyclophosphamide (AC) therapy for stage II and III breast cancer are described.Patients and Methods. Medical charts of 310 breast cancer patients who received chemotherapy at eight oncology practices during 1997 through 2001 were reviewed in this historical case series study. Prechemotherapy anemia was defined as a baseline hemoglobin value <12 g/dl. An anemic event during chemotherapy (used to define chemotherapy-induced anemia) was defined as either a drop in hemoglobin level below the threshold (≤10 g/dl), the receipt of a blood transfusion(s), or treatment with epoetin alfa. 315-472-7504; Fax: 315-479-9639; e-mail: Jkirshner@Hoacny.com Received January 9, 2003; accepted for publication September 30, 2003. ©AlphaMed Press 1083-7159/2004 The Oncologist ® Results LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Identify the prevalence and incidence of anemia in early-stage breast cancer patients and the proportion of patients untreated for anemia.2. Discuss the relationship between certain patient characteristics (i.e., age and prechemotherapy hemoglobin level) and the risk of developing moderate to severe anemia during chemotherapy.3. Explain how anemia may progress from cycle to cycle of chemotherapy and quantify the drop in hemoglobin levels for different groups of patients.Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S. Copyright law. Unauthorized reproduction is prohibited. For reprints contact: Reprints@AlphaMedPress.com anemic prechemotherapy and that the incidence of anemia increases substantially from prechemotherapy through the postchemotherapy period. This evidence appears to warrant earlier evaluation of anemia and an intervention in the prechemotherapy stage. The Oncologist 2004;9:25-32 26

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Purpose. We evaluated the incidence and severity of anemia experienced by women treated with doxorubicin and cyclophosphamide (AC) therapy for early-stage breast cancer are described. We also explored the possibility of identifying clinical characteristics that will allow early identification of women more likely to develop anemia and may require anemia treatment. Methods. This study used a historic case series from 13 oncology practices that participated in the Oncology Practice Pattern Study. The analysis focused on 411 patients who received AC chemotherapy from 1993 through 1999. Seventeen percent of the study population was excluded from the analysis due to missing data. Anemia was defined as a hemoglobin (Hb) value of < 12 g/dL. Hb ≤10 g/dL was considered the threshold value for treatment. Results. Among patients receiving AC, 18.0% was anemic prior to chemotherapy. Overall, 14.9 -16.9% of women with early-stage breast cancer who started AC chemotherapy with a normal Hb (≥12 g/dL) developed anemia. Nearly 11% developed severe to life-threatening anemia (Hb < 8 g/dL). Data on blood transfusions and erythropoietic therapy were unavailable. Multivariate logistic regression analysis showed that patients who started with a normal prechemotherapy Hb and dropped to ≤10 g/dL at some point during chemotherapy were more likely to be ≥65 years of age, have a low body surface area (< 1.78), and have four or more positive nodes. Conclusion. The incidence of anemia increased substantially from baseline to post-chemotherapy. The data suggested the importance of monitoring and managing Hb levels of patients at increased risk for developing chemotherapy-induced anemia.

Multiplex technology is an important emerging field, in diagnostic sciences, that enables the simultaneous detection of several analytes in a single sample. The light-emission spectrum of a chemiluminescent phenoxy-dioxetane luminophore can...

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