Prognostic impact of hemoglobin level and other factors in patients with high-grade gliomas treated with postoperative radiochemotherapy and sequential chemotherapy based on temozolomide

Abstract

Our results confirm the impact of well-known prognostic factors on survival. In this research, it was found that a low hemoglobin level before radiotherapy can adversely influence the prognosis of patients with malignant gliomas.

Hemoglobin Levels and Red Blood Cells Distribution Width Highlights Glioblastoma Patients Subgroup With Improved Median Overall Survival

“…The finding that low hemoglobin level is significantly associated with a lower survival rate of GBM patients is consistent with the known fact that tendency toward anemia is linked to lower survival rates in cancer patients (23,25). In the context of GBM, several works supported low hemoglobin levels as a poor prognostic factor (16)(17)(18)(19)26), though other works were less supportive of this notion. Fiorentino and Fusco (26) studied the effect of hemoglobin level of mostly biopsied elderly GBM patients (median age of 71 years) and found that a hemoglobin level cutoff of ≥12 g/dL was not significantly related to overall survival but did show better progression-free survival.…”

“…It has been somewhat investigated previously with regard to GBM prognosis, e.g., Lutterbach et al (16) pointed to low hemoglobin level as an adverse prognostic factor. This work was supported by subsequent works showing similar results (17,18). Nevertheless, some works failed to demonstrate the significant prognostic value of hemoglobin level for GBM (18,19,26).…”

“…This work was supported by subsequent works showing similar results (17,18). Nevertheless, some works failed to demonstrate the significant prognostic value of hemoglobin level for GBM (18,19,26). Another parameter recently studied is RDW, which reflects a degree of variation (anisocytosis) in the size of the circulating red cells.…”

“…As of today, the prognostic significance of KPS (6), age (7), the extent of resection (8,9), and selected molecular markers detection, i.e., MGMT methylation (10) and IDH 1/2 mutation (11,12) are well-established. Other factors such as Ki67 (13), low CD4 lymphocyte count (14), hemoglobin level (15)(16)(17)(18)(19), Red Blood cells Distribution Width (RDW) (20,21), and various anatomical features such as sub-ventricular zone involvement (22) were also shown to have prognostic value, but are still not as well-recognized as those previously mentioned.…”

Significance of Pretreatment Red Blood Cell Distribution Width in Patients with Newly Diagnosed Glioblastoma

“…Similarly, a previous study showed that the HGB level did not influence clinical outcome in elderly patients with GBM [18]. However, Céfaro et al revealed that a low HGB level was associated with shorter OS in patients with high-grade gliomas [19]. Odrazka et al identified the adverse prognostic effect of low HGB levels on the clinical outcome of GBM [20].…”