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

Clin Transl Oncol. 2013 Jun;15(6):477-83. doi: 10.1007/s12094-012-0953-5. Epub 2012 Dec 19.

Abstract

Background: The present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain.

Methods: This 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.

Results: The 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.

Conclusions: In 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / drug therapy
  • Anemia / epidemiology
  • Anemia / etiology*
  • Breast Neoplasms / complications*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / therapy
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Gastrointestinal Neoplasms / complications*
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / therapy
  • Health Surveys
  • Hematinics / therapeutic use*
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prevalence
  • Prognosis
  • Spain / epidemiology
  • Survival Rate
  • Young Adult

Substances

  • Hematinics