A mathematical model for the evaluation of amplitude of hemoglobin fluctuations in elderly anemic patients affected by myelodysplastic syndromes: correlation with quality of life and fatigue

Caocci, Giovanni; Baccoli, Roberto; Ledda, Antonio; Littera, Roberto; Nasa, Giorgio La

doi:10.1016/j.leukres.2006.05.015

Cited by 31 publications

(31 citation statements)

References 7 publications

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“…Attrition (patient drop-out or incomplete data collection) was a common feature of the studies. Only three studies reported 100% completion of HRQoL assessments [6][7][8], the sample sizes being 6, 32, and 39, respectively. In the 11 studies evaluating HRQoL as a secondary outcome, 47% patients (327/700) completed the full schedule of HRQoL assessments.…”

Section: Attritionmentioning

confidence: 99%

“…Only seven studies clearly reported a transfusion protocol. Six of these used a ''transfusion trigger'' of 80 g/l [7,[11][12][13]16,18] whilst Atoyebi et al [6] employed a trigger of 90 g/l. The protocol of three studies allowed additional red cell transfusions at clinical discretion in patients felt to have symptomatic anemia [12,16,18], although few details of these transfusions were provided.…”

Section: Transfusion Protocolsmentioning

confidence: 99%

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Quality of life and use of red cell transfusion in patients with myelodysplastic syndromes. A systematic review

et al. 2009

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The main treatment for many patients with Myelodysplastic Syndromes (MDS) remains red cell transfusion to attenuate the symptoms of chronic anemia. Fatigue can reduce a patient's health related quality of life (HRQoL), but there is little understanding of the optimal use of transfusions to improve this. A systematic review was performed to identify and appraise publications reporting the use of HRQoL instruments in patients with MDS. A total of 17 separate studies were identified that used 14 HRQoL instruments, but only one MDS disease specific HRQoL instrument (QOL-E) was reported. Two well established HRQoL instruments were most often used in MDS research (variants of the Functional Assessment of Cancer Therapy (FACT) and the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30)). Several common problems were identified in the published literature including a lack of power calculations to detect clinically relevant changes, small sample sizes and significant attrition rates for completion of HRQoL assessments, all of which limit the strength of any conclusions. There is no consensus on the optimal transfusion regimen to improve HRQoL in transfusion-dependent MDS. Future research into HRQoL within MDS is a pressing requirement. Studies should focus on the domains that are of most clinical importance to the patient as well as traditional quantitative changes of hemoglobin concentration. Am. J. Hematol. 84:671-677, 2009. V

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Section: Attritionmentioning

confidence: 99%

Section: Transfusion Protocolsmentioning

confidence: 99%

Quality of life and use of red cell transfusion in patients with myelodysplastic syndromes. A systematic review

et al. 2009

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“…Patients may require frequent transfusions to support tolerable haemoglobin levels. Fatigue, which can be disabling, is related to the chronic haemolysis and is disproportionate to anaemia (Rosse, 2000; Caocci et al , 2007). Depletion of plasma nitric oxide by free haemoglobin leads to complications associated with smooth muscle dystonias including abdominal pain, dysphagia, pulmonary hypertension and erectile dysfunction (Rosse, 2000; Parker et al , 2005; Rother et al , 2005).…”

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confidence: 99%

Eculizumab, a terminal complement inhibitor, improves anaemia in patients with paroxysmal nocturnal haemoglobinuria

et al. 2008

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Summary In paroxysmal nocturnal haemoglobinuria (PNH), chronic destruction of PNH red blood cells (RBCs) by complement leads to anaemia and other serious morbidities. Eculizumab inhibits terminal complement‐mediated PNH RBC destruction by targeting C5. In the phase III, double‐blind, placebo‐controlled, TRIUMPH study, eculizumab reduced haemolysis, stabilized haemoglobin levels, reduced transfusion requirements and improved fatigue in patients with PNH. Herein, we explored the effects of eculizumab on measures of anaemia in patients from the TRIUMPH study and the open‐label SHEPHERD study, a more heterogeneous population. Eculizumab reduced haemolysis regardless of pretreatment transfusion requirements and regardless of whether or not patients became transfusion‐dependent during treatment (P < 0·001). Reduction in haemolysis was associated with increased PNH RBC counts (P < 0·001) while reticulocyte counts remained elevated. Eculizumab‐treated patients demonstrated significantly higher levels of haemoglobin as compared with placebo in TRIUMPH and relative to baseline levels in SHEPHERD (P < 0·001 for each study). Eculizumab lowered transfusion requirement across multiple pretreatment transfusion strata and eliminated transfusion support in a majority of both TRIUMPH and SHEPHERD patients (P < 0·001). Patients who required some transfusion support during treatment with eculizumab showed a reduction in haemolysis and transfusion requirements and an improvement in fatigue. Eculizumab reduces haemolysis and improves anaemia and fatigue, regardless of transfusion requirements.

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“…Acute, cyclic hypoxia has been shown to be even more effective than chronic hypoxia in selecting aggressive, apoptosis-resistant tumor cells and promoting metastasis (e.g., [25,26,110,136,169]). Further impact of fluctuating Hb levels may be a reduced quality of life and a greater degree of fatigue [28]. Of particular interest is the fact that by using RBC transfusions, even if given in greater amounts, it is hardly possible to achieve a sufficient and, particularly, sustained increase in the Hb level.…”

Section: Risks and Limitations Of Blood Transfusionsmentioning

confidence: 99%

Erythropoiesestimulierende Substanzen: günstiges Sicherheitsprofil bei indikationskonformer Anwendung

Nowrousian¹,

Dunst

Vaupel

2008

Strahlenther Onkol

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When used as indicated, ESAs are valuable and safe drugs for the treatment of anemia and do not negatively affect patient survival. In particular, the data situation confirms the importance and correctness of the EORTC guidelines 2006 and their recently updated version. It is therefore recommended that these guidelines continue to be strictly followed in the treatment of chemotherapy-induced anemia.

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A mathematical model for the evaluation of amplitude of hemoglobin fluctuations in elderly anemic patients affected by myelodysplastic syndromes: correlation with quality of life and fatigue

Cited by 31 publications

References 7 publications

Quality of life and use of red cell transfusion in patients with myelodysplastic syndromes. A systematic review

Quality of life and use of red cell transfusion in patients with myelodysplastic syndromes. A systematic review

Eculizumab, a terminal complement inhibitor, improves anaemia in patients with paroxysmal nocturnal haemoglobinuria

Erythropoiesestimulierende Substanzen: günstiges Sicherheitsprofil bei indikationskonformer Anwendung

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