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

Abstract

Purpose

To describe the prevalence and management of anemia in cancer patients.

Methods

This cross-sectional, observational survey was conducted in Italy and Austria. Centers prespecified one day, during a 4-month enrollment window, to report specific data collected during normal clinical practice for patients with non-myeloid tumors attending for chemotherapy (±radiotherapy) treatment. The primary endpoint was the prevalence of anemia as determined using a prespecified algorithm: hemoglobin (Hb) ≤10 g/dL on/within 3 days prior to visit; ongoing anemia treatment; physician diagnosis of anemia, together with ≥1 anemia symptom.

Results

Between November 18, 2010 and March 18, 2011, data for 1412 patients were collected (Italy n = 1130; Austria n = 282). Most patients (n = 1136; 80%) had solid tumors; 809 (57%) had received ≤3 chemotherapy cycles. The prevalence of anemia was 32% (95% confidence interval: 29.4%–34.2%); 196 patients (14%) were deemed anemic based on Hb ≤10 g/dL, 131 (9%) on ongoing anemia treatment, and 121 (9%) on physician diagnosis/anemia symptom. Overall, 1153 patients (82%) had Hb data; mean (standard deviation [SD]) Hb levels were 11.7 (1.7) g/dL. In total, 456 patients (32%) had anemia symptoms: fatigue (n = 392; 28%), depression (n = 122; 9%), and dyspnea (n = 107; 8%) were most common. Fifty-one patients (4%) had had their current chemotherapy cycle delayed due to anemia. On visit day, or ≤28 days prior, 91 (6%), 188 (13%), and 81 patients (6%) had evidence of whole blood/red blood cell transfusion, erythropoiesis-stimulating agent use, or iron use, respectively.

Conclusion

On the prespecified study day, one-third of patients with non-myeloid tumors undergoing chemotherapy were found to be anemic and 13% had evidence of erythropoiesis-stimulating agent use then or in the 28 days prior.

Keywords:

• erythropoiesis-stimulating agent
• hemoglobin
• iron
• management
• transfusion

Acknowledgments

This study was sponsored by Amgen Ltd. Medical writing support (funded by Amgen [Europe] GmbH) was provided by Dawn Batty from Bioscript Stirling Ltd. Mimma Rizzo (Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Napoli, Italy) is also acknowledged for reviewing the draft manuscript. The following study investigators are also acknowledged for collecting data and for providing care for study patients, Italy: R Addeo, F Angelini, A Ardizzoia, M Botta, C Buscarino, E Cammilluzzi, E Capochiani, E Cerqui, E Cortesi, N Di Renzo, F Gaion, R Ghio, G Giglio, P Giordani, M Giordano, C Ingrosso, V Lorusso, F Malorgio, R Mattioli, C Mulas, G Mustacchi, G Palmieri, C Pasquini, V Pavone, A Pelizzari, F Piantedosi, A Pisano, G Pisapia, I Romaniello, R Segati, G Battista Speranza, R Tassara, D Toniolo, F Vaira, P Varese; Austria: T Brodowicz, W Eisterer, A Georgoulopoulos, T Grünberger, M Hubalek, R Kolb, P Neumeister, A Petzer, TC Scholl, R Schramböck, C Singer, G Steger, E Ullsperger.

Disclosure

Laura Belton is a contract biostatistician for Amgen Ltd, and Beatriz Pujol is an employee of Amgen Europe. Ferdinand Haslbauer has received funding from Amgen GmbH. The other authors report no conflicts of interest in this work.