Anaemia associated with androgen deprivation in patients with prostate cancer receiving combined hormone blockade

Abstract

Objectives To describe the incidence, time to onset and (13%) others, representing a mean absolute haemoglobin decline in this subset of 42.7 g/L. Significant extent of anaemia occurring in patients with prostate cancer receiving combined hormone blockade (CHB) symptoms related to anaemia occurred in 17 patients (13%). Anaemia and symptoms in these patients were and the timing and extent of recovery from anaemia in those patients where CHB was discontinued.easily corrected with the subcutaneous administration of recombinant human erythropoietin. Patients and methods Patients with prostate cancer were evaluated prospectively by physical examination and Conclusions The anaemia associated with androgen deprivation is significant and occurs routinely in laboratory tests at baseline and at routine intervals while receiving CHB. Of 142 patients who received men receiving CHB. It is normochromic, normocytic, temporally-related to the initiation of androgen block-CHB, 133 were evaluable for the assessment of anaemia; CHB was discontinued in 76 patients, of whom ade and usually resolves after CHB is discontinued. We suggest that patients receiving CHB undergo 64 were assessable for recovery from their anaemia. Results Haemoglobin levels declined significantly in all haematological testing at baseline, 1-2 months after initiating CHB and periodically thereafter. Patients patients from a mean baseline of 149 g/L to means of 139 g/L, 132 g/L and 131 g/L at 1, 2 and 3 months, developing anaemia should be questioned about symptoms reflecting physiological compromise (e.g. angina, respectively. Haemoglobin levels continued to decline during CHB to a mean nadir of 123 g/L at a mean of dyspnoea on exertion). In the absence of other causes, CHB should be suspected in the development of anae-5.6 months of CHB, representing a mean absolute haemoglobin decline at nadir of 25.4 g/L. In 120 of mia in patients receiving this treatment. Keywords Anaemia, androgen deprivation, combined the 133 (90%) patients, the relative decline in haemoglobin at nadir was Á10% and was Á25% in 17 hormone blockade, prostate cancer, haemoglobin hormone blockade (IHB) and recent reports have

Erythropoietin and erythropoietin receptor expression in human prostate cancer

“…41 In another study, combined hormonal blockade was associated with a significant decrease in hemoglobin in 90% of patients; this decline was related to the duration of treatment and recovered after treatment of symptomatic patients with recombinant human erythropoietin. 42 In a randomized study of patients with anemia and metastatic hormone-refractory prostate cancer, administration of higher doses of recombinant human erythropoietin was associated with increased hemoglobin, reduction of blood transfusions and improvement in quality of life compared to lower erythropoietin doses. 43 In another randomized study of anemic cancer patients, including those with prostate cancer undergoing radiotherapy, recombinant human erythropoietin administration was associated with a beneficial effect on hemoglobin levels.…”

Management of fatigue and anaemia in men treated with androgen deprivation therapy

“…10 Although the prevalence of symptomatic anaemia in published studies varies significantly between 0 9 and 37 per cent, 10 decreased haemoglobin levels can be seen in up to 90 per cent of patients receiving ADT. 11 Anaemia tends to be worse when an LHRH agonist is combined with an antiandrogen for a maximum androgen blockade than with a LHRH agonist or antiandrogen alone. 10 Similarly, a greater incidence of anaemia has been described in patients treated with LHRH agonist alone than with bicalutamide alone.…”

“…4 ADT-related anaemia is usually normochromic and normocytic. A prospective study by Strum and colleagues 11 of metastatic and non-metastatic prostate cancer patients treated with maximum androgen blockade demonstrated that decreased levels of haemoglobin can be seen within one month after starting ADT; levels continued to decline, reaching a nadir at six months with a mean absolute haemoglobin reduction of 2.54g/dl. The intensity of ADTrelated anaemia is generally mild and causes no relevant clinical repercussion in most patients.…”

“…Strum and colleagues 11 showed that although haemoglobin levels recovered to 93.5 per cent of baseline level three months after stopping hormone treatment, full haemoglobin level recoveries to baseline level were generally achieved only 24 months after treatment completion. Interestingly, the rate and extent of haemoglobin recovery was significantly lower in older patients and in those receiving ADT for more than one year.…”

Andropause: Symptom Management for Prostate Cancer Patients Treated With Hormonal Ablation

“…Strum et al reported on their experience with 133 patients treated with CAB, who had a statistically significant fall in hemoglobin, reaching a mean nadir of -2.5 g/dl at 5.6 months. Thirteen percent of those patients became symptomatic and were treated successfully with subcutaneous rHuEpo [88]. Asbell et al reported on a multicenter study that demonstrated the development of anemia in 141 patients undergoing CAB 2 months prior to pelvic radiotherapy.…”