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

• Autores: Juan Luis Steegmann Olmedillas, José Miguel Sánchez Torres, Ramón Colomer Bosch, Á. Vaz, Javier López Jiménez, José Ignacio Jalón López, Mariano Provencio Pulla, Antonio González Martín, M. Pérez
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 15, Nº. 6, 2013, págs. 477-483
• Idioma: inglés
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• Resumen

  • 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.