Chemotherapy-induced anemia: etiology, pathophysiology, and implications for contemporary practice

Bryer, Emily; Henry, David H.

doi:10.2147/ijctm.s187569

Cited by 57 publications

(63 citation statements)

References 97 publications

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“…In line with other studies, 7 , 24 fatigue was, by far, the most common side effect of chemotherapy reported by participants in the current survey. This was followed by participants considering themselves to have a weakened immune system.…”

Section: Discussionsupporting

confidence: 93%

Cancer Patients’ Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Epstein¹,

Roy²,

Aapro³

et al. 2021

PPA

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Purpose To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the “patient voice” describing how CIM impacts their daily lives. Participants and Methods Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: “In your own words, please describe how side effects from myelosuppression have impacted your life.” Results Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1–10 scale of “bothersomeness”). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24–43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family. Conclusion Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.

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Section: Discussionsupporting

confidence: 93%

Cancer Patients’ Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Epstein¹,

Roy²,

Aapro³

et al. 2021

PPA

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“…Studies seeking to gain insight into patients' perspectives on the burden of CIM are important, as hematologic side effects can have a substantial negative impact on patients' quality of life and may contribute to suboptimal treatment outcomes [1,4,6,19]. Many studies have sought to understand patients' perceptions of the symptoms associated with CIM, but few studies have been designed to better understand patients' perspectives on the overall impact of CIM and how it is managed in daily practice.…”

Section: Discussionmentioning

confidence: 99%

“…Myelosuppression is an important treatmentrelated toxicity among patients with cancer [1][2][3], and occurs when the actively dividing hematopoietic stem and progenitor cells (HSPCs) in the bone marrow, which give rise to blood cell lineages, are damaged by cytotoxic chemotherapy. Chemotherapy-induced myelosuppression (CIM) commonly manifests as anemia, neutropenia, thrombocytopenia, and/ or lymphopenia [1,[4][5][6], and often results in an increased risk of life-threatening infections, shortness of breath, fatigue, and, potentially, excess bleeding. CIM is currently managed with chemotherapy dose reductions and delays, in addition to rescue interventions that stimulate or mobilize white cells (growth factors, such as granulocyte colony-stimulating factors [G-CSFs]); replenish red blood cells (RBCs) and platelets (transfusions); or stimulate RBC precursors (growth factors, such as erythropoiesisstimulating agents [ESAs]) [4,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Patient Burden and Real-World Management of Chemotherapy-Induced Myelosuppression: Results from an Online Survey of Patients with Solid Tumors

Epstein¹,

Aapro

Roy

et al. 2020

Adv Ther

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Introduction: Chemotherapy-induced myelosuppression (CIM) is one of the most common dose-limiting complications of cancer treatment, and is associated with a range of debilitating symptoms that can significantly impact patients' quality of life. The purpose of this study was to understand patients' perspectives on how the side effects of CIM are managed in routine clinical practice. Methods: An online survey was conducted of participants with breast, lung, or colorectal cancer who had received chemotherapy treatment within the past 12 months, and had experienced at least one episode of myelosuppression in the past year. The survey was administered with predominantly close-ended questions, and lay definitions of key terms were provided to aid response selection. Results: Of 301 participants who completed the online survey, 153 (51%) had breast cancer, 100 (33%) had lung cancer, and 48 (16%) had colorectal cancer. Anemia, neutropenia, lymphopenia, and thrombocytopenia were reported by 61%, 59%, 37%, and 34% of participants, respectively. Most participants (79%) reported having received treatment for CIM, and 64% of participants recalled chemotherapy dose modifications as a result of CIM. Although most participants believed their oncologist was aware of the side effects of CIM, and treated them quickly, 30% of participants felt their oncologists did not understand how uncomfortable they were due to the side effects of CIM. Overall, 88% of participants considered CIM to have a moderate or major impact on their lives. Conclusion: The data highlight that despite the various methods used to address CIM, and the patient-focused approach of oncologists, the real-world impact of CIM on patients is substantial. Improving communication between Digital Features To view digital features for this article go to

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“…All the phytotreatments again appear to reduce HB and RBC to a lesser extent compared to the reference drug. The development of anemia, an issue with most of the cancer chemotherapeutics and is faced as chemotherapeutic agentinduced myelosuppression activity [51]. The perceived increase in neutrophils and platelet counts and a decrease in lymphocytes in all the tumor-bearing animals relate with the promotion the proliferation of cancerous cells [52].…”

Section: Intestinementioning

confidence: 99%

Anti-Melanoma Bio-Efficacy of the Plant Madhuca Longifolia and Its Enhancement Using Bioactive Principle Loaded Gold Nanoparticle

Yadav¹,

Sharma²,

Ganesh³

et al. 2020

Asian J Pharm Clin Res

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Objective: Unexplored in-vivo anti-melanoma bio-efficacy of the plant Madhuca longifolia (bark) has been carried out against C57BL/6 mice. Methods: Optimized experimental conditions of phytofabrication of gold nanoparticles were as follows: flavonoid content (1 ml, 0.5 mg/ml), sodium tetrachloroaurate dihydrate solution (2 ml, 1 mM), and sonication (15 min, 20 KHz) at pH 4. The optical properties; ultraviolet-visible spectrophotometer (UV-Vis), particles size and zeta potential (Zetasizer), miller indices; X-ray diffraction (XRD), morphology; field emission-scanning electron microscope (FE-SEM), particle size; high resolution-transmission electron microscopy (HR-TEM), surface roughness; atomic force microscopy (AFM) and elemental composition; and energy dispersive X-rays (EDX) of flavonoid loaded gold nanoparticles. In-vivo anti-melanoma bio-efficacy has been carried out against C57BL mice. Radioisotopic, hematological, and histopathological studies were carried out using standard procedures. Results: Redox potential of the total flavonoid extracted from the bark of the plant (Madhuca longifolia) has been used for the fabrication of flavonoid loaded gold nanoparticles (F@AuNp) and confirmed for the first time their significant anti-melanoma bio-efficacy. The finding is supported by hematological and histopathological studies carried out in the organs (liver, kidney, and intestine) of C57BL mice. The significant enhancement in phytofabricated F@AuNp compared to native bark extract of the plant has been assigned to enhanced stay period and nanosizing, biocompatibility, nontoxic nature, and enhanced beneficial payload to the cancerous cells. Conclusion: Such phytofabricated gold nanoparticles possess an admirable prospect for the expansion of herbal nanomedicine for anti-melanoma bio-efficacy.

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Chemotherapy-induced anemia: etiology, pathophysiology, and implications for contemporary practice

Cited by 57 publications

References 97 publications

Cancer Patients’ Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Cancer Patients’ Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Patient Burden and Real-World Management of Chemotherapy-Induced Myelosuppression: Results from an Online Survey of Patients with Solid Tumors

Anti-Melanoma Bio-Efficacy of the Plant Madhuca Longifolia and Its Enhancement Using Bioactive Principle Loaded Gold Nanoparticle

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