High prevalence of anaemia and limited use of therapy in cancer patients: a Belgian survey (Anaemia Day 2008)

Abstract

Objectives The aim of this study is to provide relevant and accurate information on prevalence and treatment patterns of anaemia in Belgian cancer patients. Methods The Anaemia Day 2008 survey was a single visit, multi-centre, non-interventional study in adult cancer patients under systemic therapy (chemotherapy, hormonal, immunological and/or targeted therapy) and/or radiotherapy. Efforts were made to enrol the maximum number of patients seen in each centre that day. Patients signed an informed consent and relevant data were collected from their files, i.e. disease and disease stage, cancer therapy and anti-anaemic treatment, including transfusions and the use of erythropoietin stimulating agents (ESA). A blood count of each included patient was performed. Haemoglobin (Hb) values (grams per decilitre) were classified into four categories to assess the severity of anaemia, as defined by WHO: no anaemia: Hb≥12 g/dL; mild 10≤Hb≤11.9 g/dL; moderate 8≤Hb≤9.9 g/dL; severe Hb< 8 g/dL. Univariate and multivariate analyses were carried out with anaemia as the dependent variable. Results A total of 1,403 eligible patients aged 63±13 years (mean age±SD) were enrolled in 106 oncology or haematology centres. The mean Hb level (±SD) was 11.6 g/dL (±1.8 g/dL) and the prevalence of anaemia (Hb<12 g/dL) was 55.7% (95% CI, 53.1-58.3%), respectively, 35.9% mild, 17.8% moderate and 2.1% severe anaemia. Anaemia was more frequent in females than in males, and in patients with haematological malignancies (73.4%) than in those with solid tumours (51.4%; p<0.001). Anaemia prevalence was higher in hospitalised patients (75.5%) compared to those seen in one-day-clinic (54.3%) or in consultation (33.9%; p<0.001), and in patients treated with chemotherapy (61.3%) compared to those receiving radiotherapy (34.4%) or hormonal therapy (19.5%; p<0.001). There was a clear correlation between severity of anaemia and WHO performance status (p< 0.001). Among anaemic patients, 53.1% received no treatment (mean Hb 10.8±0.9 g/dL). Among the anaemic patients who received therapy for their anaemia (mean Hb 9.7±1.1 g/dL), the most frequent treatments were RBC transfusions (42%), ESA (34.6%), transfusions + ESA (12%), ESA+iron (7.9%) and iron alone (3.5%). Comparison to the ECAS survey shows that there has been no major change in attitude towards anaemia management in the last decade.

Anemia prevalence and treatment practice in patients with non-myeloid tumors receiving chemotherapy

“…However, when only the patients receiving chemotherapy at enrollment were considered in the ECAS, 50% of them were found to be anemic (hemoglobin <12 g/dL)1 – a figure higher than observed here (39% were anemic based on hemoglobin levels ≤11 g/dL). Similarly, the prevalence of anemia, defined as hemoglobin levels <12 g/dL, was higher in the Belgian survey than in the present study (56% versus 39%) 14. However, the Belgian survey included patients with myelodysplasia, which was an exclusion criterion in the present study, and so increased reporting of anemia is to be expected in the former.…”

Anaemia in Cancer Patients Undergoing Radiotherapy and Chemotherapy at the National Hospital, Abuja

“…This finding was in agreement with the studies done by other researchers [3,12]. The sex distribution above was found to be in contrast to many other studies which showed that male cancer patients generally were in higher proportion than female cancer patients [13][14][15][16][17]. This may be due to the differences in population studied or treatment options at the facility.…”

“…Out of 201 patients studied, 54% (108) had WHO performance status of 0 while 46% (93) had WHO performance status of 1. The correlation between patients's WHO performance status Hb levels was elucidated by Natacha et al in their study of 1,403 cancer patients [13]. In their study, there were more patients at enrolment with poor performance status at lower Hb level than at higher Hb levels.…”

The Effect of the APPRISE Mandate on Use of Erythropoiesis-Stimulating Agents and Transfusion Rates in Patients With Ovarian Cancer Receiving Chemotherapy

“…11 The prevalence of all grades of anemia has been estimated to be as high as 65% and more specifically as high as 20% for grade 3 and 4 anemia (hemoglobin level, G8 g/dL). 1,12,13 The importance of anemia in patients with cancer stems from its association with a poor prognosis and a 65% greater risk in overall mortality.…”