Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

Abstract

BackgroundThe present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain.MethodsThis was a multicenter, observational, cross-sectional study performed in 2008. Eligible patients were ≥18 years, with non-myeloid malignancies treated with systemic therapy [chemotherapy (CT), hormonal therapy or immunotherapy]. Anaemia was defined according to WHO as haemoglobin (Hb) < 12 g/dL.ResultsThe study included 214 patients with a median age of 63 years (range 20–91), 58 % women, 73 % with solid tumours, and 79 % with advanced disease. CT was used in 91 % of patients (26 % with platinum compounds), hormonal therapy in 8.5 %, and immunotherapy in 8.5 %. In our study, 48.1 % of patients [95 % confidence interval (CI) 45.2–58.6] showed anaemia (31 % symptomatic): 42.0 % mild (10 ≤ Hb ≤ 11.9 g/dL), 5.6 % moderate (8 ≤ Hb ≤ 9.9 g/dL), and 0.5 % severe (Hb < 8 g/dL). A higher prevalence was observed in patients treated with CT (51 vs. 20 %, p = 0.01), platinum-based CT (70 vs. 47 %, p = 0.01) or palliative CT (61 vs. 39 %, p = 0.003). Anaemia was also more frequent in patients with more than three lines of CT (83 %) and in the fourth or subsequent CT cycle (58 %). Management in the previous 4 weeks in patients with anaemia was: 62 % did not receive treatment (92 % mild), 24 % received erythropoiesis-stimulating agents (ESAs), 14 % received iron and 8.7 % received transfusion.ConclusionsIn Spanish hospitals, about half of patients with non-myeloid malignancies undergoing systemic therapy fulfilled anaemia criteria (87 % mild). Approximately two-third of patients with anaemia do not receive specific treatment and ESA use is below current guidelines.

Anemia prevalence and treatment practice in patients with non-myeloid tumors receiving chemotherapy

“…Some country-specific survey data have been reported in the last few years,12–15 but no data have been reported to date for Italy and Austria. Here we expand on these recent reports and provide information on the prevalence of anemia in patients undergoing chemotherapy in the clinical practice setting in Italy and Austria.…”

Intravenous iron therapy for anemic cancer patients: a review of recently published clinical studies

“…A paper by Maccis et al [2] indicates that 63% of cancer patients were anemic; in that observational study, hemoglobin concentrations were inversely correlated with inflammatory markers, hepcidine, ferritin, erythropoietin, and reactive oxygen species. In another paper from Spain, by Steegman et al [3], the prevalence of anemia was 48% and a high rate was associated with cisplatin-based chemotherapy, palliative chemotherapy, and with more than three lines of chemotherapy. Link and Schmitz [4] found a prevalence of hemoglobin level below 12 g/dl of 49% and stressed that two thirds of these patients were not treated for anemia, which does not reflect current clinical practice guidelines, such as those recommended by ESMO (European Society of Medical Oncology) [5].…”

Clinical and economic effect of administration of red blood product transfusions in an outpatient supportive care cancer service

“…Although severity may differ due to age, sex and race, it is a frequent symptom of patients with cancer. It is more commonly observed in patients with hematological malignancies (60-80% in myelodysplastic syndromes) compared with non-hematological tumors (~40% of all patients) (1)(2)(3). The causes of anemia in patients with cancer are heterogeneous and may be associated with patient characteristics, the type of cancer itself or the administration of oncological treatment (4,5).…”

“…Patients with solid tumors most commonly develop mild anemia (30% of all patients with cancer). However, a minority of patients also develop moderate (9%) or severe anemia (1%) (2). When mild, anemia is often asymptomatic, but can be characterized by various symptoms, including pallor of the skin and mucous membranes, tachycardia, tachypnea, asthenia and fatigability, chest pain, syncope and lethargy (2,3).…”