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
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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