Prevalence and management of anaemia in haematologic cancer patients receiving cyclic nonplatinum chemotherapy: results of a prospective national chart survey

Abstract

Objectives: Anaemia is common in patients with haematologic malignancies. In contrast to solid tumours there are only a few studies exploring anaemia in haematologic cancers. The aim of this study was to determine the prevalence of anaemia (haemoglobin [Hb] <12 g/dL) in patients with chronic lymphocytic leukemia (CLL), multiple myeloma (MM), non-Hodgkin's lymphoma (NHL), and Hodgkin's disease (HD) who were scheduled to receive cyclic chemotherapy. Predictive factors for anaemia development and anaemia treatment were also assessed.

Methods: This prospective chart survey was conducted at 35 oncology centers in Austria. A total of 273 patients were followed through four cycles of nonplatinum chemotherapy, and Hb-levels and anaemia therapy were documented.

Results: At baseline, prevalence of anaemia was greatest in patients with MM (77.4%). Prevalence of anaemia increased for all malignancies after cycle 4, with the largest increases noted for patients with NHL (from 35.1% at baseline to 73.7%) and HD (from 21.9% to 54.5%). Cyclic chemotherapy and prior anticancer treatment indicated an increased risk for developing anaemia. Notably, 27.5% of patients with Hb levels <10.5 g/dL remained untreated. Transfusions were most often given to patients with severe anaemia (Hb < 8 g/dL), and erythropoietin most often given to patients with mild or moderate anaemia.

Conclusions: Our data confirm that anaemia prevalence in patients with haematologic malignancies is high and increases with chemotherapy. The current practice of anaemia management in these patients leaves room for improvement.