Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production

Abstract

Summary. Many studies have been done in order to elucidate the pathogenesis of the anaemia of chronic disorders accompanying cancer, with conflicting results. This is probably due to the heterogeneity of the patient population selected for these studies (many patients treated by chemotherapy). To avoid this pitfall, in this study a very homogenous group of chemotherapy and radiotherapy-naive patients with lung cancer were selected. Serum erythropoietin and soluble transferrin receptor measurements suggested that the anaemia of non-treated lung cancer is mainly due to an impaired erythroid marrow response to erythropoietin stimulation. However, a relative inadequacy of erythropoietin production may also contribute.

Hepcidin inhibits in vitro erythroid colony formation at reduced erythropoietin concentrations

“…22 A similar study in adult patients with lung cancer found that the primary contributor to anemia was impaired erythropoiesis, but also observed a blunted Epo response. 23 In contrast, it has been suggested that inavailability of iron is the dominant factor in the anemia of juvenile rheumatoid arthritis. 24 A complete picture of the contribution of hepcidin or any other mediator to the pathogenesis of ACD requires identification of its contributions to these different processes.…”

Preoperative hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma

“…Although most patients with endometrial carcinoma present with postmenopausal vaginal bleeding, this is rarely severe enough to cause anemia. Tumors can produce or induce cytokines such as interleukins, interferon gamma, and tumor necrosis factor that can induce hemolysis, suppress erythropoiesis, and inhibit the response of erythroid progenitor cells to erytropoietin (Spivak 1994;Dowlati et al 1997). Absolute or relative erytropoietin deWciency seems to be the Wnal pathway leading to anemia in patients with tumors (Moliterno and Spivak 1996).…”

“…The thrombocytosis was previously found to be related with poor prognostic factors in ovarian carcinoma (Bozkurt et al 2004;Zeimet et al 1994), cervical (Hernandez et al 1992(Hernandez et al , 2000Lopes et al 1994), and endometrial carcinomas (Tamussino et al 2001;Menczer et al 1996;Gucer et al 1998;Scholtz et al 2000;Ayhan et al 2006). Tumors can produce or induce cytokines such as interleukins, interferon gamma, and tumor necrosis factor that can induce hemolysis, suppress erythropoiesis, and inhibit the response of erythroid progenitor cells to erytropoietin (Spivak 1994;Dowlati et al 1997). Absolute or relative erytropoietin deWciency seems to be the Wnal pathway leading to anemia in patients with tumors (Moliterno and Spivak 1996).…”

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

“…As for thrombocytosis and anemia, we are surprised to find out that thrombocytosis appeared with anemia together, except in NSCLC. Although patients with gastric cancer, cervical cancer, and endometrial carcinoma were in a high risk of bleeding, Jale Matindir thought that [22] this was rarely severe enough to cause anemia, while cytokines induced by tumors, such as interleukins, interferon gamma, and tumor necrosis factors, can induce hemolysis, suppress erythropoiesis, and inhibit the response of erythroid progenitor cells to erythropoietin [25,26]. Other probable explanations include disorders of iron metabolism [27].…”