The pathogenesis of anemia in patients with carcinoma

Hyman, George A.; Harvey, Jane E.

doi:10.1016/0002-9343(55)90123-6

Cited by 59 publications

(16 citation statements)

References 5 publications

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“…But macrophages in the reticulo-endothelial system also have a marked capacity to produce prostaglandins, and PCGE2 in particular (Humes et al, 1977) and this capacity is increased when macrophages are stimulated (Morley et al, 1979). The difference in red-cell haeme turnover between Groups A and B might therefore also reflect a difference in immunological response, compatible with the earlier hypothesis that hyperphagocytosis produces the anaemia in patients with malignant tumours (Friedel, 1965;Hyman & Harvey, 1955;Magarey & Baum, 1970;Salky et al, 1967;Schacter et al, 1979).…”

Section: Discussionsupporting

confidence: 65%

“…The error of the 51Cr-labelling method is large however, especially in the near-normal range. In other studies, red-cell survival has been found to be shorter in cancer patients, both with and without anaemia (Hyman & Harvey, 1955;Ultman, 1958 (Leblond et al, 1971) but were not more frequent in the patient groups than in the control group, and cannot be ascribed to the finding. A few other hypotheses seem valid for discussion.…”

Section: Discussionmentioning

confidence: 77%

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Anaemia in patients with solid tumours and the role of erythrocyte deformability

Mercke¹

1981

Br J Cancer

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The deformability of erythrocytes, which is a factor of utmost importance both for capillary perfusion and for determining erythrocyte life span, has been studied in patients with solid tumours and in healthy subjects. Deformability was significantly decreased in all patients, especially those with anaemia. In this latter group of patients, carboxyhaemoglobin saturation of blood (COHb), reflecting erythrocyte haemoglobin breakdown, was also significantly increased, and this increase was closely correlated with the degree of impaired deformability of the erythrocytes. In the group of patients without anaemia, where erythrocyte deformability was also impaired, no such correlation was found. In 4 patients with Hodgkin's disease and fever as part of B symptoms, erythrocyte deformability decreased during fever and returned to normal when fever subsided. In 2 of these patients the administration of a prostaglandin-synthesis inhibitor (indomethacin) evoked a deformability, which was even better than during periods without fever. Since fever in Hodgkin patients with B symptoms has been attributed to the production of prostaglandins, these results may suggest a relationship between prostaglandin production and erythrocyte deformability in patients with malignant tumours. The close correlation between the degree of decrease in erythrocyte deformability and COHb levels in the patients with anaemia might indicate a role for prostaglandins in the production of anaemia of malignancy.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 77%

Anaemia in patients with solid tumours and the role of erythrocyte deformability

Mercke¹

1981

Br J Cancer

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“…The multifocal tumor model avoids all of these problems by synchronizing the onset and progress of the systemic effects of the final stage of cancer among the individuals of the experimental group (7,8). Under the latter conditions, the hemolytic component of cancer anemia is of particular importance as described for humans by Hyman and Harvey in the early 50s (4). These authors demonstrated what is generally recognized in oncology, namely, that in terminal cancer patients even the half-life of transfused RBC is markedly reduced, so that frequent transfusions are of little help in maintaining reasonable Hb levels.…”

Section: Pair-fedmentioning

confidence: 99%

“…Cancer anemia includes a hemolytic component which markedly increases in the final stage of the illness, when even transfused red blood cells (RBC) are rapidly destroyed (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…However, if instead of the usual unifocal tumor growth model, the studies are initiated using multifocal simultaneous tumor inoculations (simulating the metastatic dissemination of the final stage), the systemic effects of cancer, including anemia, appear rapidly and synchronously in all animals (7,8). The development of anemia under these conditions is similar to that found in terminal cancer patients, in which the rate of RBC destruction is very high (4,9). This multifocal model using the Walker 256 tumor therefore seems to be particularly suited for the study of the hemolytic component of cancer anemia.…”

Section: Introductionmentioning

confidence: 99%

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The hemolytic component of cancer anemia: effects of osmotic and metabolic stress on the erythrocytes of rats bearing multifocal inoculations of the Walker 256 tumor

Vido

Cavalcanti

Guimarães

et al. 2000

Braz J Med Biol Res

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Cancer anemia is classified as an anemia of chronic diseases, although it is sometimes the first symptom of cancer. Cancer anemia includes a hemolytic component, important in the terminal stage when even transfused cells are rapidly destroyed. The presence of a chronic component and the terminal complications of the illness limit studies of the hemolytic component. A multifocal model of tumor growth was used here to simulate the terminal metastatic dissemination stage (several simultaneous inoculations of Walker 256 cells). The hemolytic component of anemia began 3-4 days after inoculation in 100% of the rats and progressed rapidly thereafter: Hb levels dropped from 14.9 ± 0.02 to 8.7 ± 0.06 from days 7 to 11 (~5 times the physiologically normal rate in rats) in the absence of bleeding. The development of anemia was correlated (r 2 = 0.86) with the development of other systemic effects such as anorexia. There was a significant decrease in the osmotic fragility of circulating erythrocytes: the NaCl concentration causing 50% lysis was reduced from 4.52 ± 0.06 to 4.10 ± 0.01 (P<0.01) on day 7, indicating a reduction in erythrocyte volume. However, with mild metabolic stress (4-h incubation at 37 o C), the erythrocytes showed a greater increase in osmotic fragility than the controls, suggesting marked alteration of erythrocyte homeostasis. These effects may be due to primary plasma membrane alterations (transport and/or permeability) and/or may be secondary to metabolic changes. This multifocal model is adequate for studying the hemolytic component of cancer anemia since it is rapid, highly reproducible and causes minimal animal suffering.

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Acclimatization to a Simulated Altitude of 18,000 Feet in a Patient with Metastatic Cancer

Barach¹

1957

Arch Intern Med

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The pathogenesis of anemia in patients with carcinoma

Cited by 59 publications

References 5 publications

Anaemia in patients with solid tumours and the role of erythrocyte deformability

Anaemia in patients with solid tumours and the role of erythrocyte deformability

The hemolytic component of cancer anemia: effects of osmotic and metabolic stress on the erythrocytes of rats bearing multifocal inoculations of the Walker 256 tumor

Acclimatization to a Simulated Altitude of 18,000 Feet in a Patient with Metastatic Cancer

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