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

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

J L Steegmann  1 , J M Sánchez Torres, R Colomer, Á Vaz, J López, I Jalón, M Provencio, A González-Martín, M Pérez
Affiliations
Multicenter Study

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

J L Steegmann et al. Clin Transl Oncol. 2013 Jun.

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.

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Figures

Fig. 1
Fig. 1
Prevalence of anaemia in cancer patients treated with systemic therapy
Fig. 2
Fig. 2
Prevalence of anaemia in different subgroups according to patient characteristics, type of tumour, symptoms related to anaemia and systemic therapy
Fig. 3
Fig. 3
Therapeutic management of anaemia (previous 4 weeks and current visit) in patients with Hb < 12 g/dL at study inclusion (n = 103)
See this image and copyright information in PMC

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