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

Original Article

Summary

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.

Key words

Anaemia haematologic cancers haemoglobin chemotherapy erythropoietin 

Prävalenz und Therapie der Anämie bei Patienten mit hämatologischen Neoplasien unter nicht-platinhaltiger Chemotherapie: Ergebnisse einer prospektiven, österreichischen Beobachtungsstudie

Zusammenfassung

Hintergrund

Anämie ist eine häufige Komorbidität bei Tumorpatienten. Im Gegensatz zu soliden Tumoren liegen bezüglich der Tumoranämie bei hämatologischen Malignomen nur wenige Daten vor. Ziel der vorliegenden Untersuchung war daher die Bestimmung der Anämieprävalenz unter laufender Chemotherapie bei Patienten mit Non-Hodgkin Lymphomen (NHL), Multiplem Myelom (MM), Morbus Hodgkin (HD) und chronisch lymphatischer Leukämie (CLL). Weiterhin sollten mögliche Risikofaktoren zur Anämie-Entwicklung, sowie das therapeutische Management der Anämie ermittelt werden.

Methoden

An 35 österreichischen Zentren wurde bei 273 konsekutiven Patienten eine prospektive Dokumentation der Hämoglobin (Hb)-Werte vor, während und nach der Gabe von vier Zyklen nicht-platinhaltiger Chemotherapie durchgeführt. Anämie wurde definiert als ein Hb-Wert < 12 g/dL. Weiterhin wurde die jeweils angewendete Behandlungsform der Anämie erfasst.

Ergebnisse

Zu Therapiebeginn wiesen Patienten mit MM die höchste Anämieprävalenz auf (77,4%). Im Laufe der 4 Zyklen Chemotherapie erhöhte sich diese bei allen Tumorentitäten, mit der stärksten Zunahme bei Patienten mit NHL (von 35,1% vor Therapiebeginn auf 73,7%) und HD (von 21,9% auf 54,5%). Die Verabreichung einer Chemotherapie, sowie eine vorherige Antitumortherapie waren mit einem erhöhten Anämierisiko assoziiert. Transfusionen erhielten vorzugsweise Patienten mit schwerer Anämie (Hb<8 g/dL), während rekombinantes humanes Erythropoetin am häufigsten bei Patienten mit milder bis mäßiggradiger Anämie verabreicht wurde. 27,5% der Patienten mit Hb<10,5 g/dl erhielten keine Anämietherapie.

Schlussfolgerungen

Die Anämieprävalenz bei Patienten mit hämatologischen Tumoren ist hoch und nimmt im Laufe einer systemischen Chemotherapie deutlich zu. Die derzeitige Praxis der Anämietherapie bei hämatologischen Neoplasien außerhalb klinischer Studien ist noch zu optimieren.

Schlüsselwörter

Anämie hämatologische Neoplasie Hämoglobin Chemotherapie Erythropoetin 

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Copyright information

© Springer 2004

Authors and Affiliations

  1. 1.Division of Haematology and OncologyInnsbruck University HospitalInnsbruckAustria
  2. 2.Institute for Applied StatisticsJohannes Kepler UniversityLinzAustria

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