Cancer Related Anemia in the Era of Erythropoietin Stimulating Agents (ESA)Uncertainty: A Single Cancer Institution Experience.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5085-5085
Author(s):  
Hikmat Abdel-Razeq ◽  
Shadi B Hijjawi ◽  
Hazem Abdulelah ◽  
Yousef Ismael ◽  
Rula Amarin ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Combined Treatment ◽  
Disease Stage ◽  
Severe Anemia ◽  
Primary Cancer ◽  
Mild Anemia ◽  
Erythropoietin Stimulating Agents ◽  
Prevalence Of Anemia

Abstract Abstract 5085 Anemia is the most common hematological abnormality in cancer patients. Unfortunately, it is often under-recognized and under-treated. The pathogenesis of cancer anemia is complex and most of the time multifactorial; involving factors related to the tumor itself or its therapy. Recombinant human erythropoietin stimulating agents (ESA) was widely used to prevent and treat cancer and chemotherapy-related anemia. However, many recent studies involving patients with different kind of cancers at different stages of their disease suggested a negative impact on disease progression and survival when such ESA were used to keep Hemoglobin (Hb) at a higher level. The US Food and Drug Administration (FDA) announced revisions and warning to restrict ESA indications. This report describes the prevalence of anemia in cancer patients and its management given the recent confusion and uncertainties. Methods We retrospectively reviewed all consecutive adult cancer patients admitted to regular medical units between Jan and Dec, 2008. Patients admitted to Leukemia, Bone Marrow Transplantation and Intensive Care Units were excluded. Demographic features, reasons for admission, primary cancer diagnosis and disease stage were determined. All patients with Hb value < 12 g/dL at any time during admission were considered anemic. Treatment offered for anemia was also reviewed. Subsequent admissions for the same patients during the study period were also followed up. Results 959 patients (51% males, median age 55 years, range 18- 91) admitted 1862 times were included. Reasons for admission at time of enrollment included chemotherapy (23%), infections including neutropenic fever (20%), palliative and supportive care (15%). Other reasons included pulmonary, neurological, renal and electrolyte imbalances. Primary cancer diagnosis included: Gastrointestinal (21%), Breast (16%), Lymphoma and Multiple Myeloma (16%), and Lung (11%). At time of enrollment, 55% of patients had advanced stage disease. Anemia at any time during admission was detected in 755 (78.7%) patients. Mean Hb value for anemic patients was 9.51 g/dL (range 3.5-11.9, median 9.6). Severe anemia (Hb < 8) was documented in 16.7%, moderate anemia (Hb 8-10) in 41.9% and mild anemia (Hb > 10) in 41.5% of the patients. Majority (69%) of the patients were not offered any treatment for their anemia. Among the total group, blood transfusion was offered for 25%, supplements (including iron, folate and or vitamin B12) for 3.3%. ESA were offered for only 1.1%. Few patients (2.1%) had combined treatment. Mean Hb value at which treatment was started was 8 g/dL, while mean Hb for the patients who were not treated was 10.2 g/dL. Most of the patients (94%) with severe anemia, 32% with the moderate, and 5% of the patients with mild anemia were treated as shown in the table. Conclusions Anemia among adult cancer patients admitted to regular medical units is quiet common. Given the recent FDA warning and the many confusing studies, the prevalence of anemia in cancer patients was found to be high; many of such patients were not offered any treatment. The threshold to start treatment was highly dependent on its severity. Blood transfusion was the most common treatment method. Quality improvement projects should be implemented to better recognize and treat anemia in cancer patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Joint effect of pre-operative anemia and perioperative blood transfusion on outcomes of colon-cancer patients undergoing colectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Zheng Liu ◽  
Jia-Jun Luo ◽  
Kevin Y Pei ◽  
Sajid A Khan ◽  
Xiao-Xu Wang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Death Rate ◽  
Joint Effect ◽  
Severe Anemia ◽  
Joint Effects ◽  
Mild Anemia ◽  
Operative Complications ◽  
Perioperative Blood Transfusion

Abstract Background Both pre-operative anemia and perioperative (intra- and/or post-operative) blood transfusion have been reported to increase post-operative complications in patients with colon cancer undergoing colectomy. However, their joint effect has not been investigated. The purpose of this study was to evaluate the joint effect of pre-operative anemia and perioperative blood transfusion on the post-operative outcome of colon-cancer patients after colectomy. Methods We identified patients from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database 2006–2016 who underwent colectomy for colon cancer. Multivariate logistic regression analysis was employed to assess the independent and joint effects of anemia and blood transfusion on patient outcomes. Results A total of 35,863 patients—18,936 (52.8%) with left-side colon cancer (LCC) and 16,927 (47.2%) with right-side colon cancer (RCC)—were identified. RCC patients were more likely to have mild anemia (62.7%) and severe anemia (2.9%) than LCC patients (40.2% mild anemia and 1.4% severe anemia). A total of 2,661 (7.4%) of all patients (1,079 [5.7%] with LCC and 1,582 [9.3%] with RCC) received a perioperative blood transfusion. Overall, the occurrence rates of complications were comparable between LCC and RCC patients (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.95–1.07; P = 0.750). There were significant joint effects of anemia and transfusion on complications and the 30-day death rate (P for interaction: 0.010). Patients without anemia who received a transfusion had a higher risk of any complications (LCC, OR = 3.51; 95% CI = 2.55–4.85; P &lt; 0.001; RCC, OR = 3.74; 95% CI = 2.50–5.59; P &lt; 0.001), minor complications (LCC, OR = 2.54; 95% CI = 1.63–3.97; P &lt; 0.001; RCC, OR = 2.27; 95% CI = 1.24–4.15; P = 0.008), and major complications (LCC, OR = 5.31; 95% CI = 3.68–7.64; P &lt; 0.001; RCC, OR = 5.64; 95% CI = 3.61–8.79; P &lt; 0.001), and had an increased 30-day death rate (LCC, OR = 6.97; 95% CI = 3.07–15.80; P &lt; 0.001; RCC, OR = 4.91; 95% CI = 1.88–12.85; P = 0.001) than patients without anemia who did not receive a transfusion. Conclusions Pre-operative anemia and perioperative transfusion are associated with an increased risk of post-operative complications and increased death rate in colon-cancer patients undergoing colectomy.

scholarly journals Prevalence of anemia among pregnant women in rural Koppal: a study from teaching hospital, Koppal, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3792 ◽  
Author(s):  
Seema B. N.
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Peripheral Blood Smear ◽  
Poverty Line ◽  
World Health ◽  
Major Public Health Problem ◽  
Severe Anemia ◽  
Mild Anemia ◽  
High Prevalence ◽  
Prevalence Of Anemia

Background: Anemia is the nutritional deficiency disorder and 56% of all women living in developing countries are anaemic according to World Health Organization. India has the highest prevalence of anaemia and 20% of total maternal deaths are due to anemia. To determine the prevalence of anemia and factors influencing its causation among pregnant women.           Methods: This is the study of 1769 pregnant women which was conducted in a rural population of Koppal district, Karnataka, India, from June 2016 to November 2016 i.e. a period of 6 months. This longitudinal prospective observational study was conducted in the district hospital of Koppal. Anemia was classified as per the Indian Council of Medical Research (ICMR) criteria. The diagnosis of anemia was undertaken by peripheral blood smear examination and standard hemoglobin estimation by shale’s method.Results: The average age of pregnant women was 23.5 years, ranging between 18 and 40 years. Most of the women belonged to below poverty line (BPL) families (84.6%) and Hindu religion (98%). Regarding education, 28.9% were illiterates. The mean haemoglobin level was found to be 8.95. Prevalence of anemia was 96.5% among the pregnant females in this region of rural Koppal. Out of these 22.47% had mild anemia, 56.30% had moderate anemia, 14.98% had severe anemia and 2.73% very severe anemia according to ICMR classification of anemia.Conclusions: High prevalence of anemia among pregnant women indicates anemia to be a major public health problem in the rural community and indicates strict implementation of National Nutrition Anemia prophylaxis programme. Factors such as socioeconomic status, education, birth interval, and gravida contribute to this high prevalence.

scholarly journals Burden of anemia in hospital attendees in Tayma general hospital, Tabuk, Saudi Arabia

2017 ◽  
Vol 5 (1) ◽  
pp. 47
Author(s):  
Prabakaran Jayaraman ◽  
Mohammad Alshay ◽  
Saad Eid Alanazi ◽  
Abdul Malik Hasan Al Maswari ◽  
Zakaria Hammad ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Data Entry ◽  
Public Health Problem ◽  
The Body ◽  
Reproductive Age ◽  
Severe Anemia ◽  
Lower Margin ◽  
Cross Sectional ◽  
Mild Anemia ◽  
Prevalence Of Anemia

Background: Anemia, a low hemoglobin (Hb) status in the body is a serious nutritional public health problem in the world. It causes divergent morbidity and mortality in the affected population. Prevalence of anemia among women of reproductive age (women ages 15-49 years) in Saudi Arabia was 40.30% in 2011. In this study, we attempted to explore the burden of anemia in Hospital attendees in Saudi Arabia. Methods: A cross sectional study was conducted with the laboratory hematological values of walk-in clients from January 2016 and February 2016. Client's sex, Hb, HCT, MCV, MCH, MCHC values were collected. Hb values categorized as mild anemia: Male: 11-12.9 gm/dl; Female: 11-11.9 g/dl., moderate anemia 8-11 gm/dl and severe anemia <8 g/dl. Data entry done was using Microsoft Excel and data analysis by STATA 15. Results: Out of total 2805 client's data, 49% (n=1377) were male and 51% (n=1428) were females. The mean Hb% was 12.31 g/dl (SD–2.54), 11.50 g/dl in females and 13.13 g/dl in males. The overall prevalence of anemia was 48.73% (CI: 46.87%-50.6%) as per WHO criteria and it was higher in females (45.53%, CI: 42.88-48.21) in men and 51.82% (CI: 49.19-54.44) in women). Severe anemia was also higher in women (Male: 2.76% vs. Females: 7.49%) while mild anemia was high in men (Male: 28.61% vs. Female: 17.79%). Prevalence of anemia was 25.6% and 40.7% if lower margin of Hb kept at 11 g/dl and 12 g/dl respectively. Conclusions: The prevalence of anemia in Tayma region was high which needs integrated intervention at different levels to improve Hb status in the community. 

scholarly journals Increased Outdoor PM2.5 Concentration Is Associated with Moderate/Severe Anemia in Children Aged 6–59 Months in Lima, Peru

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Valeria C. Morales-Ancajima ◽  
Vilma Tapia ◽  
Bryan N. Vu ◽  
Yang Liu ◽  
Dulce E. Alarcón-Yaquetto ◽  
...  
Keyword(s):  
Meteorological Data ◽  
Hemoglobin Concentration ◽  
World Health ◽  
Severe Anemia ◽  
Mild Anemia ◽  
High Prevalence ◽  
Health Organization ◽  
Prevalence Of Anemia ◽  
Combined Data ◽  
Pm2.5 Concentration

Anemia affects 1.62 billion people worldwide. Although iron deficiency is the main cause of anemia, several other factors may explain its high prevalence. In this study, we sought to analyze the association between outdoor particulate matter PM2.5 levels with anemia prevalence in children aged 6–59 months residing in Lima, Peru (n = 139,368), one of the cities with the worst air pollution in Latin America. The study period was from 2012 to 2016. Anemia was defined according to the World Health Organization (Hb < 11 g/dL). PM2.5 values were estimated by a mathematical model that combined data observed from monitors, with satellite and meteorological data. PM2.5 was analyzed by quintiles. Multiple linear and logistic regressions were used to estimate the associations between hemoglobin concentration (beta) and anemia (odds ratio) with PM2.5, after adjusting by covariates. Prevalence of anemia was 39.6% (95% confidence interval (CI): 39.3–39.9). Mild anemia was observed in 30.8% of children and moderate/severe in 8.84% of children. Anemic children compared with nonanemic children are mainly males, have low body weight, higher rate of stunting, and live in an environment with high PM2.5 concentration. A slight decrease in hemoglobin (4Q B: −0.03, 95% CI: −0.05 to −0.02; 5Q B: −0.04, 95% CI: −0.06 to −0.01) and an increase in the probability of moderate/severe anemia (4Q OR: 1.18, 95% CI: 1.10–1.27; 5Q OR: 1.18, 95% CI: 1.08–1.29) were observed with increased exposure to PM2.5. We conclude that outdoor PM2.5 levels were significantly associated with decreased hemoglobin values and an increase in prevalence of moderate/severe anemia in children under 5 years old.

scholarly journals Anemia and perioperative mortality in Non-cardiac Surgery patients: a secondary analysis based on a single-center retrospective study

2020 ◽  
Author(s):  
Xueying Luo ◽  
Feng Li ◽  
Haofei Hu ◽  
Baoer Liu ◽  
Sujing Zheng ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Severe Anemia ◽  
Perioperative Mortality ◽  
Icu Admission ◽  
Mild Anemia ◽  
Postoperative Blood Transfusion ◽  
Doubly Robust Estimation ◽  
Anemia Group ◽  
Doubly Robust

Abstract Background : Evidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in non-cardiac surgery patients over 18 years of age. Methods: This study was a retrospective analysis of the electronic medical records of 90,784 patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. Multivariate regression, propensity score analysis, doubly robust estimation, and an inverse probability-weighting model was used to ensure the robustness of our findings. Results : We identified 85,989 patients, of whom75, 163 had none or mild anemia(Hemoglobin>90g/L) and 10,826 had moderate or severe anemia(Hemoglobin≤90g/L). 8,857 patients in each study exposure group had similar propensity scores and were included in the analyses. In the doubly robust model, postoperative 30-day mortality rate was increased by 0.51% (n = 219) in moderate or severe anemia group (Odds Ratio, 1.510; 95% Confidence Interval(CI), 1.049 to 2.174) compared with none or mild anemia group (2.47% vs. 1.22%, P<0.001). Moderate or severe anemia was also associated with increased postoperative blood transfusion rates (OR, 5.608; 95% CI, 4.026 to 7.811, P < 0.001).There was no statistical difference in Intensive Care Unit(ICU) admission rate among different anemia groups within 30 days after surgery (P=0.104). Discussion: In patients undergoing non-cardiac surgery over 18 years old, moderate or severe preoperative anemia would increase the occurrence of postoperative blood transfusion and the risk of death, rather than ICU admission within 30 days after surgery.

scholarly journals Prevalence of anemia in school children in the age group of 8 to 14 years in Thiruvarur, Tamilnadu, India

2019 ◽  
Vol 6 (4) ◽  
pp. 1428
Author(s):  
P. Raja ◽  
R. Rajaselvan
Keyword(s):  
Iron Deficiency ◽  
School Children ◽  
Hemoglobin Concentration ◽  
Population Level ◽  
Deficiency Anemia ◽  
Severe Anemia ◽  
Age Group ◽  
Nutritional Anemia ◽  
Mild Anemia ◽  
Prevalence Of Anemia

Background: Iron deficiency is responsible for most of the nutritional anemia. Hemoglobin concentration is a reliable indicator of anemia at the population level, as opposed to clinical measures which are subjective and therefore have more room for error. Measuring Hemoglobin concentration is relatively easy and inexpensive, and this measurement is frequently used as a proxy indicator of iron deficiency. To study the association of certain risk factors with the prevalence of anemia in school children in the age group of 8-14 years.Methods: The study was conducted from April 2017 to March 2018 in Department of Paediatrics, Government Thiruvarur Medical College, Thiruvarur. The study population consisted of school children in the age group of 8 to 14 years fulfilling the inclusion and exclusion criteria. The sample size was 250. Complete hematological investigations was done to each child for differential diagnosis of anemia.Results: Majority of the children studied had a normal BMI 38.4% (n=96), 16.8% (n=42) were classified as overweight, 9.2% (n=23) were classified as obese. 22.8% (n=57) were classified as having thinness. 12.8% (n=32) were classified as having severe thinness. Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10). Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10).Conclusions: The prevalence of anemia was significantly higher in female children (64.91%) compared to male children (42.65%). The prevalence of anemia is highest in children with severe thinness (78.13%) followed by children with obesity (73.91%). The most common type of anemia in our study was iron deficiency anemia. Majority of the children were suffering from anemia of mild severity. There was no statistically significant correlation between the prevalence of anemia in children and age and socioeconomic status.

scholarly journals Anemia and perioperative mortality in Non-cardiac Surgery patients: a secondary analysis based on a single-center retrospective study

2020 ◽  
Author(s):  
Xueying Luo ◽  
Baoer Liu ◽  
Sujing Zheng ◽  
Liping Yang ◽  
Ya Li ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Severe Anemia ◽  
Perioperative Mortality ◽  
Icu Admission ◽  
Mild Anemia ◽  
Postoperative Blood Transfusion ◽  
Doubly Robust Estimation ◽  
Anemia Group ◽  
Doubly Robust

Abstract Introduction: Evidence regarding the relationship between anemia and perioperative prognosis is controversial. The study was conducted to highlight the specific relationship between anemia and perioperative mortality in non-cardiac surgery patients over 18 years of age. Methods: This study was a retrospective analysis of the electronic medical records of 90,784 patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. Multivariate regression, propensity score analysis, doubly robust estimation, and an inverse probability-weighting model was used to ensure the robustness of our findings. Results We identified 85,989 patients, of whom75, 163 had none or mild anemia and 10,826 had moderate or severe anemia. 8,857 patients in each study exposure group had similar propensity scores and were included in the analyses. In the doubly robust model, postoperative 30-day mortality rate was increased by 0.51% (n = 219) in moderate or severe anemia group (odds ratio, 1.510; 95% CI, 1.049 to 2.174) compared with none or mild anemia group (2.47% vs. 1.22%, P<0.001). Moderate or severe anemia was also associated with increased postoperative blood transfusion rates (OR, 5.608; 95% CI, 4.026 to 7.811, P < 0.001).There was no statistical difference in ICU admission rate among different anemia groups within 30 days after surgery (P=0.104). Discussion: In patients undergoing non-cardiac surgery over 18 years old, moderate or severe preoperative anemia would increase the occurrence of postoperative blood transfusion and the risk of death, rather than ICU admission within 30 days after surgery.

scholarly journals Psychosocial Distress Among Cancer Patients: A single Institution Experience at the State of Qatar

2021 ◽  
Author(s):  
Azza Adel Hassan ◽  
Azar Naveen Saleem ◽  
Saad Jobran Eziada ◽  
Abdelsadiq Bashir ◽  
Amna Gameil ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Psychosocial Distress ◽  
Disease Stage ◽  
Tumor Type ◽  
Single Institution ◽  
Cancer Treatments ◽  
Distress Level ◽  
High Distress

Abstract Introduction The prevalence of psychosocial distress is up to 45% among cancer patients. It is crucial to identify and treat distress. The aim of the study is to report on the prevalence of distress among cancer patients, analyze the variable causes of distress and to study the effect of the disease stage using the Distress Thermometer. Methods We studied distress among 3 groups, each consisting of 100 patients: those initially diagnosed, patients undergoing treatment, and patients who were referred to the palliative team. Different variables such as time of screening, sex, age, nationality, and tumor type were analyzed.Results There was an overall distress incidence of 62% (level ≥ 4) and out of that 17% of the patients had severe distress (level >7). Similarly, there was 75% of distress among patients who were referred to palliative care, compared to 56% of patients at initial diagnosis and 54% for those undergoing cancer treatments. In addition, women (69%) had more distress (53%). Expatriates had high distress, compared to Qataris (64.3% versus 51%). Breast (69%) and lung (70%) cancer patients had the highest level of distress. Physical causes of distress were the most common followed by emotional causes.Conclusion There is a substantially higher overall incidence of distress among cancer patients in Qatar. Distress should be assessed in patients at cancer diagnosis and at the time of disease progression. Screening alone isn’t enough, the different causes of distress should be identified and addressed by the appropriate interventions.

scholarly journals PREVALENCE OF ANEMIA IN PATIENTS WITH SOLID TUMORS: A SINGLE CENTER CROSS-SECTIONAL STUDY AT A TERTIARY CARE CENTER IN WEST INDIA

2020 ◽  
pp. 1-3
Author(s):  
Kunal Kishore
Keyword(s):  
Solid Tumors ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Severe Anemia ◽  
Cross Sectional ◽  
Mild Anemia ◽  
Clinical Complexity ◽  
Oncology Unit ◽  
Prevalence Of Anemia

Background: Anemia is one of the most frequently reported problems in patients with cancer. It is a frequent finding in cancer patients, occurring in >40% of cases. Methods: To evaluate the distribution, the main causes, and the possible correlations of anemia with type and stage of cancer in a population of patients with solid tumors, we carried out a cross sectional observational study on a cohort of 127 subjects. Results: Anemia was observed in 58.4% of patients, with an increase in the prevalence with increasing age regardless of gender difference. In more than one-half (59.1% )of anemic patients, anemia was mild. Moderate to severe anemia was seen in 27.6% and 13.4% cases respectively. Iron deficiency was the commonest etiology for anemia in cases with solid tumors (54.33%) followed by anemia due to chronic disease (41.73%). Mild anemia was relatively more common in cases with CNS tumors and Breast carcinoma while severe anemia was associated with lymphomas and colorectal carcinoma. Conclusion: Our data confirm the high prevalence of anemia in patients hospitalized in an Oncology unit, with a remarkable burden of mild forms, and of chronic inflammation's pathogenic mechanism. Correlations with comorbidities and duration of hospital stay highlight the crucial part played by anemia in determining the clinical complexity of such patients.

Sign in / Sign up

Export Citation Format

Share Document