Baseline anemia and anemia grade are independent prognostic factors for stage IV non‑small cell lung cancer

Chen, Cheng; Song, Zhengbo; Wang, Wenxian; Zhou, Juying

doi:10.3892/mco.2021.2221

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…Besides cachexia, anemia is one of the most frequently reported complications of cancer. Approximately one-third of newly diagnosed patients with cancer suffer from anemia before any treatment ( 1 , 2 ). Most of these patients have mild anemia, but even such low pretreatment hemoglobin (Hb) levels are associated with reduced survival ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Approximately one-third of newly diagnosed patients with cancer suffer from anemia before any treatment ( 1 , 2 ). Most of these patients have mild anemia, but even such low pretreatment hemoglobin (Hb) levels are associated with reduced survival ( 2 , 3 ). Moreover, in response to tumor-reductive therapy, 75% of patients will develop anemia ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Remodeling of metabolism and inflammation by exercise ameliorates tumor-associated anemia

et al. 2021

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A considerable number of patients with cancer suffer from anemia, which has detrimental effects on quality of life and survival. The mechanisms underlying tumor-associated anemia are multifactorial and poorly understood. Therefore, we aimed at systematically assessing the patho-etiology of tumor-associated anemia in mice. We demonstrate that reduced red blood cell (RBC) survival rather than altered erythropoiesis is driving the development of anemia. The tumor-induced inflammatory and metabolic remodeling affect RBC integrity and augment splenic phagocyte activity promoting erythrophagocytosis. Exercise training normalizes these tumor-associated abnormal metabolic profiles and inflammation and thereby ameliorates anemia, in part, by promoting RBC survival. Fatigue was prevented in exercising tumor-bearing mice. Thus, exercise has the unique potential to substantially modulate metabolism and inflammation and thereby counteracts pathological remodeling of these parameters by the tumor microenvironment. Translation of this finding to patients with cancer could have a major impact on quality of life and potentially survival.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Remodeling of metabolism and inflammation by exercise ameliorates tumor-associated anemia

et al. 2021

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“…Since cancer is a chronic consumption disease with advanced tumors, patients' hemoglobin levels are significantly correlated with their survival rates and tumor progression (24,25). Preoperative anemia or anemia is substantially associated with tumor recurrence and cancer-specific mortality (9,26). Using serum albumin as an indicator of nutritional status can be employed to assess the survival rate of patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated that a series of hematological indicators reflecting the inflammation or nutritional state of the body, including albumin (8), hemoglobin (9), and lymphocytes (10), are related to NSCLC prognosis. However, the disadvantage of these single indicators is that each indicator reflects only one aspect of inflammation or nutrition.…”

Section: Introductionmentioning

confidence: 99%

The preoperative hemoglobin, albumin, lymphocyte, and platelet score is a prognostic factor for non-small cell lung cancer patients undergoing adjuvant chemotherapy: a retrospective study

et al. 2022

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Background: Developing a simple, reliable and low-cost biomarkers is crucial to predict the prognosis of non-small cell lung cancer (NSCLC) patients receiving adjuvant chemotherapy. The score combining hemoglobin and albumin levels and lymphocyte and platelet counts (HALP score) is reportedly related to the prognosis of multiple types of tumors. However, few studies have focused on its prognostic value in patients with NSCLC. Our study aimed to investigate the prognostic role of the HALP score and develop a valuable prognostic model for patients with NSCLC undergoing adjuvant chemotherapy.Methods: A total of 362 individuals with NSCLC undergoing adjuvant chemotherapy between 2013 and 2015 were included. The HALP score was computed according to the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (g/L)/platelets (g/L). Furthermore, demographic characteristic, including age, sex, smoking status, and drinking history, were collected from case report forms at admission. The main outcomes were overall survival (OS) and disease-free survival (DFS), which were assessed using Kaplan-Meier analysis with log-rank test. Furthermore, Cox regression analysis was employed to assess the prognostic role of HALP in NSCLC.Results: We found the significant associations of clinicopathological features, including sex, pathological stage, tumor size, and lymph node metastasis (LNMets) in univariate Cox regression analysis. In multivariate analysis, NSCLC patients with a high HALP score were significantly associated with lower OS [hazard ratio (HR): 0.707; 95% confidence interval (CI): 0.503-0.995] and DFS (HR: 0.671; 95% CI: 0.491-0.916). The Kaplan-Meier analysis showed that a low HALP score predicted poorer OS (P=0.02) and DFS (P<0.01) outcomes. Furthermore, we performed stratification analysis by tumor node metastasis (TNM) stage, and the result indicated a low HALP score predicted poor OS (P=0.01) and DFS (P=0.04) outcomes in stage III-IV NSCLC patients. Conclusions: Our study demonstrated that the HALP score might be a suitable prognostic index for NSCLC patients undergoing adjuvant chemotherapy. Combining demographic and clinicopathological features with the HALP score may help clinicians predict survival and treatment outcomes. Keywords: Non-small cell lung cancer (NSCLC); score combining hemoglobin and albumin levels and lymphocyte and platelet counts (HALP score); overall survival (OS); disease-free survival (DFS)

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“…An analysis [ 22 ] of 186 NSCLC patients with EGFR mutations treated with first-line tyrosine kinase inhibitors found that anemic patients had shorter median OS than non-anemic patients [24.83 (95% CI, 17.49–32.17) months vs. 42.10 (95% CI, 31.87–52.34) months, P = 0.031], and anemia [HR = 2.573 (95% CI, 1.12–5.90), P = 0.026] was the only independent factor predicting poor OS. Chen et al [ 23 ] reported that baseline anemia and anemia grade were independent prognostic factors in patients with stage IV NSCLC. They found that patients without baseline anemia had longer OS than patients with baseline anemia (28.0 vs. 17.4 months, P < 0.001) and OS decreased with increasing anemia grade, with patients with grade 0 anemia having the longest OS (28.0 months) and patients with grade 3 and 4 anemia having the shortest OS (8.6 months).…”

Section: Discussionmentioning

confidence: 99%

Baseline anemia predicts a poor prognosis in patients with non-small cell lung cancer with epidermal growth factor receptor mutations: a retrospective study

et al. 2022

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Background Anemia is relatively common in cancer patients, and baseline anemia is associated with poor survival in patients with non-small cell lung cancer (NSCLC). However, there is a lack of large-sample studies of patients with NSCLC with epidermal growth factor receptor (EGFR) mutations. Methods We retrospectively analyzed anemia‑related data for patients with NSCLC and EGFR mutations who were admitted to Zhejiang Cancer Hospital from January 2013 to June 2019 and treated with targeted therapy. The patients’ clinicopathological features were evaluated by χ2 tests and the relationships between clinical characteristics and prognosis were investigated using Kaplan–Meier and multivariate Cox regression analyses. Results A total of 2,029 patients treated with EGFR-tyrosine kinase inhibitors (TKIs) were finally enrolled in this study, of whom 24.6% had baseline anemia. Patients without baseline anemia had longer median overall survival (OS) than patients with baseline anemia (36.10 vs. 29.10 months, P = 0.001), and patients with grade < 2 anemia had longer median OS than those with grade ≥ 2 anemia (35.00 vs. 25.10 months, P < 0.001). Multivariate analyses identified baseline anemia as a factor predicting a poor prognosis in terms of OS in patients with EGFR mutations. Conclusions Baseline anemia is a significant factor predicting a poor prognosis in terms of OS in patients with NSCLC and EGFR mutations treated with targeted therapy. A higher grade of baseline anemia may also be related to shorter OS. And a higher risk of EGFR-mutated patients who had received targeted therapy could also be observed.

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Baseline anemia and anemia grade are independent prognostic factors for stage IV non‑small cell lung cancer

Cited by 11 publications

References 22 publications

Remodeling of metabolism and inflammation by exercise ameliorates tumor-associated anemia

Remodeling of metabolism and inflammation by exercise ameliorates tumor-associated anemia

The preoperative hemoglobin, albumin, lymphocyte, and platelet score is a prognostic factor for non-small cell lung cancer patients undergoing adjuvant chemotherapy: a retrospective study

Baseline anemia predicts a poor prognosis in patients with non-small cell lung cancer with epidermal growth factor receptor mutations: a retrospective study

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