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Incidence of anemia, leukocytosis, and thrombocytosis in patients with solid tumors in China

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Tumor Biology

Abstract

Despite the fact that malignancies are associated with hematological abnormalities, some clinical studies have been unable to detect such a relation. The aim of our study was to detect the prevalence of pretreatment hematologic abnormalities in patients with common solid tumors and to determine if such a profile could be used for prognostic evaluations. We identified all patients in Cancer Center of Sun Yat-sen University who were diagnosed as solid tumors (breast carcinoma, hepatocellular carcinoma, nasopharyngeal carcinoma, esophageal carcinoma, gastric cancer, cervical carcinoma, endometrial cancer, renal cell carcinoma, and non-small cell lung cancer) between January 2000 and August 2009. All subjects were investigated regarding levels of white blood cells, platelets, and hemoglobin concentration. We identified 3,180 patients with solid tumors and 285 patients with benign diseases for the final analysis. The percentages of leukocytosis, anemia, and thrombocytosis in patients with solid tumors ranged from 4.0% to 25.6%, 3.3% to 29.2%, and 2.1% to 9.7%, respectively. The multivariate Cox analysis revealed that anemia was an independent prognostic factor in patients with breast cancer (P = 0.006), hepatocellular carcinoma (P = 0.002), nasopharyngeal carcinoma (P = 0.008), and esophageal carcinoma (P = 0.001). Leukocytosis was an independent prognostic factor in patients with cervical cancer (P = 0.007). The incidence of hematological abnormalities in Chinese patients with solid tumors was relatively lower than that of the counterparts in the Western countries. A pretreatment anemia or leukocytosis can serve as a useful marker to predict outcome of patients in some of the solid tumors.

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References

  1. Tranum BL, Haut A. Thrombocytosis: platelet kinetics in neoplasia. J Lab Clin Med. 1974;84:615–9.

    PubMed  CAS  Google Scholar 

  2. Li AJ, Madden AC, Cass I, Leuchter RS, Lagasse LD, Karlan BY. The prognostic significance of thrombocytosis in epithelial ovarian carcinoma. Gynecol Oncol. 2004;92:211–4.

    Article  PubMed  Google Scholar 

  3. Lerner DL, Walsh CS, Cass I, Karlan BY, Li AJ. The prognostic significance of thrombocytosis in uterine papillary serous carcinomas. Gynecol Oncol. 2007;104:91–4.

    Article  PubMed  Google Scholar 

  4. Gungor T, Kanat-Pektas M, Sucak A, Mollamahmutoglu L. The role of thrombocytosis in prognostic evaluation of epithelial ovarian tumors. Arch Gynecol Obstet. 2009;279:53–6.

    Article  PubMed  Google Scholar 

  5. Pedersen LM, Milman N. Diagnostic significance of platelet count and other blood analyses in patients with lung cancer. Oncol Rep. 2003;10:213–6.

    PubMed  Google Scholar 

  6. Tomita M, Shimizu T, Hara M, Ayabe T, Onitsuka T. Prognostic impact of thrombocytosis in resectable non-small cell lung cancer. Interact Cardiovasc Thorac Surg. 2008;7:613–5.

    Article  PubMed  Google Scholar 

  7. Gislason T, Nou E. Sedimentation rate, leucocytes, platelet count and haemoglobin in bronchial carcinoma: an epidemiological study. Eur J Respir Dis. 1985;66:141–6.

    PubMed  CAS  Google Scholar 

  8. Erdemir F, Kilciler M, Bedir S, Ozgok Y, Coban H, Erten K. Clinical significance of platelet count in patients with renal cell carcinoma. Urol Int. 2007;79:111–6.

    Article  PubMed  Google Scholar 

  9. Symbas NP, Townsend MF, El-Galley R, Keane TE, Graham SD, Petros JA. Poor prognosis associated with thrombocytosis in patients with renal cell carcinoma. BJU Int. 2000;86:203–7.

    Article  PubMed  CAS  Google Scholar 

  10. Pedersen LM, Milman N. Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J. 1996;9:1826–30.

    Article  PubMed  CAS  Google Scholar 

  11. Costantini V, Zacharski LR, Moritz TE, Edwards RL. The platelet count in carcinoma of the lung and colon. Thromb Haemost. 1990;64:501–5.

    PubMed  CAS  Google Scholar 

  12. Ikeda M, Furukawa H, Imamura H, Shimizu J, Ishida H, Masutani S, et al. Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol. 2002;9:287–91.

    Article  PubMed  Google Scholar 

  13. Monreal M, Fernandez-Llamazares J, Pinol M, Julian JF, Broggi M, Escola D, et al. Platelet count and survival in patients with colorectal cancer—a preliminary study. Thromb Haemost. 1998;79:916–8.

    PubMed  CAS  Google Scholar 

  14. Shimada H, Oohira G, Okazumi S, Matsubara H, Nabeya Y, Hayashi H, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg. 2004;198:737–41.

    Article  PubMed  Google Scholar 

  15. Chen CC, Yang CF, Yang MH, Lee KD, Kwang WK, You JY, et al. Pretreatment prognostic factors and treatment outcome in elderly patients with de novo acute myeloid leukemia. Ann Oncol. 2005;16:1366–73.

    Article  PubMed  Google Scholar 

  16. Suzuki K, Aiura K, Kitagou M, Hoshimoto S, Takahashi S, Ueda M, et al. Platelets counts closely correlate with the disease-free survival interval of pancreatic cancer patients. Hepatogastroenterology. 2004;51:847–53.

    PubMed  Google Scholar 

  17. Brockmann MA, Giese A, Mueller K, Kaba FJ, Lohr F, Weiss C, et al. Preoperative thrombocytosis predicts poor survival in patients with glioblastoma. Neuro Oncol. 2007;9:335–42.

    Article  PubMed  Google Scholar 

  18. Gogus C, Baltaci S, Filiz E, Elhan A, Beduk Y. Significance of thrombocytosis for determining prognosis in patients with localized renal cell carcinoma. Urology. 2004;63:447–50.

    Article  PubMed  Google Scholar 

  19. Lu CC, Chang KW, Chou FC, Cheng CY, Liu CJ. Association of pretreatment thrombocytosis with disease progression and survival in oral squamous cell carcinoma. Oral Oncol. 2007;43:283–8.

    Article  PubMed  CAS  Google Scholar 

  20. Taucher S, Salat A, Gnant M, Kwasny W, Mlineritsch B, Menzel RC, et al. Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost. 2003;89:1098–106.

    PubMed  CAS  Google Scholar 

  21. Hefler L, Mayerhofer K, Leibman B, Obermair A, Reinthaller A, Kainz C, et al. Tumor anemia and thrombocytosis in patients with vulvar cancer. Tumour Biol. 2000;21:309–14.

    Article  PubMed  CAS  Google Scholar 

  22. Metindir J, Bilir DG. Preoperative hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma. J Cancer Res Clin Oncol. 2009;135:125–9.

    Article  PubMed  CAS  Google Scholar 

  23. Qiu MZ, Yuan ZY, Luo HY, Ruan DY, Wang ZQ, Wang FH, et al. Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol. 2010;31:255–60.

    Article  PubMed  Google Scholar 

  24. Chen MH, Chang PM, Chen PM, Tzeng CH, Chu PY, Chang SY, et al. Prognostic significance of a pretreatment hematologic profile in patients with head and neck cancer. J Cancer Res Clin Oncol. 2009;135:1783–90.

    Article  PubMed  Google Scholar 

  25. Dowlati A, R'Zik S, Fillet G, Beguin Y. Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production. Br J Haematol. 1997;97:297–9.

    Article  PubMed  CAS  Google Scholar 

  26. Spivak JL. Cancer-related anemia: its causes and characteristics. Semin Oncol. 1994;21:3–8.

    PubMed  CAS  Google Scholar 

  27. DeRienzo DP, Saleem A. Anemia of chronic disease: a review of pathogenesis. Tex Med. 1990;86:80–3.

    PubMed  CAS  Google Scholar 

  28. Moliterno AR, Spivak JL. Anemia of cancer. Hematol Oncol Clin North Am. 1996;10:345–63.

    Article  PubMed  CAS  Google Scholar 

  29. Kasuga I, Makino S, Kiyokawa H, Katoh H, Ebihara Y, Ohyashiki K. Tumor-related leukocytosis is linked with poor prognosis in patients with lung carcinoma. Cancer. 2001;92:2399–405.

    Article  PubMed  CAS  Google Scholar 

  30. Mroczko B, Groblewska M, Wereszczynska-Siemiatkowska U, Okulczyk B, Kedra B, Laszewicz W, et al. Serum macrophage-colony stimulating factor levels in colorectal cancer patients correlate with lymph node metastasis and poor prognosis. Clin Chim Acta. 2007;380:208–12.

    Article  PubMed  CAS  Google Scholar 

  31. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001;91:2214–21.

    Article  PubMed  CAS  Google Scholar 

  32. Dunst J, Kuhnt T, Strauss HG, Krause U, Pelz T, Koelbl H, et al. Anemia in cervical cancers: impact on survival, patterns of relapse, and association with hypoxia and angiogenesis. Int J Radiat Oncol Biol Phys. 2003;56:778–87.

    PubMed  Google Scholar 

  33. Baghi M, Wagenblast J, Hambek M, Moertel S, Gstoettner W, Strebhardt K, et al. Pre-treatment haemoglobin level predicts response and survival after tpf induction polychemotherapy in advanced head and neck cancer patients. Clin Otolaryngol. 2008;33:245–51.

    Article  PubMed  CAS  Google Scholar 

  34. Rades D, Schild SE, Bahrehmand R, Zschenker O, Alberti WA, Rudat VR. Prognostic factors in the nonsurgical treatment of esophageal carcinoma with radiotherapy or radiochemotherapy: the importance of pretreatment hemoglobin levels. Cancer. 2005;103:1740–6.

    Article  PubMed  Google Scholar 

  35. Yang MH, Wu MZ, Chiou SH, Chen PM, Chang SY, Liu CJ, et al. Direct regulation of twist by hif-1alpha promotes metastasis. Nat Cell Biol. 2008;10:295–305.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was funded by National Natural Science Foundation of China grant 30672408, Guangzhou Bureau of Science and Technology grant 2006Z3-E0041, and Sun Yat-sen University 985 Program Initiation Fund (China). We thank Professor Qing Liu in the Epidemiology Department for his suggestion in the statistical analysis. Besides, we thank the staff members in the Department of Medical Oncology, NPC Oncology, Gastric Surgery Oncology, Thoracic Surgery Oncology, Hepatocellular Surgery Oncology, and Gynecology Oncology at Sun Yat-sen University Cancer Center for their assistance.

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Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China

    Miao-zhen Qiu, Rui-hua Xu, Dan-yun Ruan, Zhuang-hua Li, Hui-yan Luo, Kai-yuan Teng, Zhi-qiang Wang, Yu-hong Li & Wen-qi Jiang

  2. Department of Medical Oncology, Sun Yat-Sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, People’s Republic of China

    Miao-zhen Qiu, Rui-hua Xu, Dan-yun Ruan, Zhuang-hua Li, Hui-yan Luo, Kai-yuan Teng, Zhi-qiang Wang, Yu-hong Li & Wen-qi Jiang

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  1. Miao-zhen Qiu
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Correspondence to Rui-hua Xu.

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Qiu, Mz., Xu, Rh., Ruan, Dy. et al. Incidence of anemia, leukocytosis, and thrombocytosis in patients with solid tumors in China. Tumor Biol. 31, 633–641 (2010). https://doi.org/10.1007/s13277-010-0079-8

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  • DOI: https://doi.org/10.1007/s13277-010-0079-8

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