澳大利亚癌症贫血调查：成年癌症患者贫血情况的简要描述

The Australian Cancer Anaemia Survey: a snapshot of anaemia in adult patients with cancer.

作者信息

Seshadri Tara, Prince H Miles, Bell David R, Coughlin Paul B, James Philip P B, Richardson Gary E, Chern Boris, Briggs Peter, Norman John, Olver Ian N, Karapetis Chris, Stewart John

机构信息

Peter MacCallum Centre, Melbourne, VIC.

出版信息

Med J Aust. 2005 May 2;182(9):453-7. doi: 10.5694/j.1326-5377.2005.tb06784.x.

DOI:10.5694/j.1326-5377.2005.tb06784.x

PMID:15865588

Abstract

OBJECTIVE

To evaluate the frequency and management of anaemia in Australian adults with solid and haematological malignancies.

DESIGN

6-month observational, prospective, multicentre study.

PARTICIPANTS

694 patients recruited from outpatient oncology clinics in 24 hospitals in five Australian states between 9 April 2001 and 31 July 2001.

MAIN OUTCOME MEASURES

Frequency of anaemia (haemoglobin [Hb] level < 120 g/L) at enrolment and over ensuing 6 months, by tumour type, disease status and cancer treatment; anaemia treatment and "trigger" Hb level for this treatment.

RESULTS

Participants had median age 60 years, and 61% were women. Prevalence of anaemia at enrolment was 35% (199/562), with 78% of these 199 having mild anaemia (Hb, 100-119 g/L). Frequency of anaemia (either present at enrolment or developing during the study) was 57% overall (323/566), and varied with tumour type, from 49% (lymphoma/myeloma) to 85% (urogenital cancer). Patients who received radiotherapy either in combination or concomitant with chemotherapy were more likely to have anaemia (73%) than those receiving chemotherapy alone (58%) (P = 0.004). Of all chemotherapy patients not anaemic at enrolment, 23% developed anaemia by the second monthly follow-up. Independent predictors for anaemia in chemotherapy patients were low baseline Hb level (odds ratio [OR], 5.4; 95% CI, 2.7-10.9) and use of platinum chemotherapeutic agents (OR, 4.8; 95% CI, 2.1-11.4) (P < 0.001). Anaemia was treated in 41% of patients with anaemia at enrolment--by transfusion (36%), iron (5%) and erythropoietic agents (2%). Frequency of anaemia treatment varied between tumour types, from 19% (breast cancer) to 60% (leukaemia). The mean "trigger Hb" for initiating transfusion was 95 g/L.

CONCLUSIONS

Anaemia is prevalent among Australian patients with cancer managed in hospital oncology units. Its management varies between tumour types. Many patients do not receive treatment for their anaemia.

摘要

目的

评估澳大利亚患有实体瘤和血液系统恶性肿瘤的成年人贫血的发生率及处理情况。

设计

为期6个月的观察性、前瞻性、多中心研究。

参与者

2001年4月9日至2001年7月31日期间，从澳大利亚五个州24家医院的门诊肿瘤诊所招募的694例患者。

主要观察指标

入组时及随后6个月内按肿瘤类型、疾病状态和癌症治疗情况划分的贫血（血红蛋白[Hb]水平<120 g/L）发生率；贫血治疗情况及该治疗的“触发”Hb水平。

结果

参与者的中位年龄为60岁，61%为女性。入组时贫血患病率为35%（199/562），这199例中有78%为轻度贫血（Hb，100 - 119 g/L）。贫血发生率（入组时存在或研究期间发生）总体为57%（323/566），并因肿瘤类型而异，从49%（淋巴瘤/骨髓瘤）到85%（泌尿生殖系统癌症）不等。接受联合放疗或同步化疗的患者比仅接受化疗的患者更易发生贫血（73%对58%）（P = 0.004）。在所有入组时无贫血的化疗患者中，23%在第二次月度随访时出现贫血。化疗患者贫血的独立预测因素为基线Hb水平低（比值比[OR]，5.4；95%可信区间[CI]，2.7 - 10.9）和使用铂类化疗药物（OR，4.8；95%CI，2.1 - 11.4）（P < 0.001）。入组时贫血的患者中有41%接受了贫血治疗——输血（36%）、铁剂（5%）和促红细胞生成剂（2%）。贫血治疗发生率因肿瘤类型而异，从19%（乳腺癌）到60%（白血病）不等。开始输血的平均“触发Hb”为95 g/L。