Medical Oncology Department, Institut Gustave Roussy, Villejuif, France.
Eur J Cancer. 2012 Jan;48(1):101-7. doi: 10.1016/j.ejca.2011.09.011. Epub 2011 Oct 31.
To describe the management of anaemia in 2009-2010 in France in patients with haematological malignancies (HM) or solid tumours (ST).
Retrospective observational study in 57 centres, enrolling adult patients with HM or ST treated for an episode of anaemia (duration of the episode ≥ 3 months occurring in the last 12 months).
220 patients with ST (breast, 18%; lung, 18%) and 56 with HM (lymphoma, 60%) were included (median age, 68 years; female, 53%). Mean haemoglobin level at anaemia diagnosis was 9.3 ± 1.4 g/dL (<8 g/dL for 16%) and 9.8 ± 1.1g/dL (<8 g/dL for 6%) in HM and ST patients, respectively. At least one parameter of iron deficiency (ferritin, transferrin saturation) was assessed in 26% of HM and 19% of ST patients. Treatment of anaemia included erythropoiesis-stimulating agents (ESA) for 98% of HM and 89% of ST patients. Iron was prescribed to 14% (oral, 12%; intravenous, 2%) of HM patients and to 42% (oral, 17%; intravenous, 25%) of ST patients. The rates of blood transfusions were high: 70% in HM and 46% in ST patients; transfusions alone or administrated with ESA were more frequent in patients with Hb <8 g/dL.
Although recent guidelines recommend evaluating iron deficiency and correcting anaemia by using intravenous iron, our study in cancer patients evidenced that ESA and blood transfusions are still frequently used as the treatment of anaemia in cancer patients. Iron deficiency is insufficiently assessed (only one patient among five) and as a consequence iron deficiency is most likely insufficiently treated.
描述 2009-2010 年法国血液系统恶性肿瘤（HM）或实体瘤（ST）患者贫血的管理情况。
在 57 个中心进行回顾性观察性研究，纳入因贫血发作（过去 12 个月中发作持续时间≥3 个月）而接受治疗的 HM 或 ST 成年患者。
纳入 56 例 HM（淋巴瘤，60%）和 220 例 ST（乳腺癌，18%；肺癌，18%）患者（中位年龄，68 岁；女性，53%）。HM 和 ST 患者贫血诊断时的平均血红蛋白水平分别为 9.3±1.4 g/dL（16%＜8 g/dL）和 9.8±1.1 g/dL（6%＜8 g/dL）。HM 和 ST 患者中分别有 26%和 19%评估了至少一项缺铁参数（铁蛋白、转铁蛋白饱和度）。贫血治疗包括 98%的 HM 和 89%的 ST 患者使用促红细胞生成素刺激剂（ESA）。14%（口服，12%；静脉内，2%）的 HM 患者和 42%（口服，17%；静脉内，25%）的 ST 患者开具了铁剂。输血率较高：HM 患者为 70%，ST 患者为 46%；Hb＜8 g/dL 的患者更常单独输血或ESA 联合输血。
尽管最近的指南建议评估缺铁并通过静脉内铁来纠正贫血，但我们在癌症患者中的研究表明，ESA 和输血仍然经常被用于癌症患者的贫血治疗。缺铁评估不足（五例患者中只有一例），因此很可能缺铁治疗不足。
