Servicio de Hematología, Hematology Department, Instituto de Investigación Sanitaria (IIS-IP), Hospital Universitario de la Princesa, Diego de Leon, 62, 28006, Madrid, Spain.
Clin Transl Oncol. 2013 Jun;15(6):477-83. doi: 10.1007/s12094-012-0953-5. Epub 2012 Dec 19.
The present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain.
This was a multicenter, observational, cross-sectional study performed in 2008. Eligible patients were ≥18 years, with non-myeloid malignancies treated with systemic therapy [chemotherapy (CT), hormonal therapy or immunotherapy]. Anaemia was defined according to WHO as haemoglobin (Hb) < 12 g/dL.
The study included 214 patients with a median age of 63 years (range 20-91), 58 % women, 73 % with solid tumours, and 79 % with advanced disease. CT was used in 91 % of patients (26 % with platinum compounds), hormonal therapy in 8.5 %, and immunotherapy in 8.5 %. In our study, 48.1 % of patients [95 % confidence interval (CI) 45.2-58.6] showed anaemia (31 % symptomatic): 42.0 % mild (10 ≤ Hb ≤ 11.9 g/dL), 5.6 % moderate (8 ≤ Hb ≤ 9.9 g/dL), and 0.5 % severe (Hb < 8 g/dL). A higher prevalence was observed in patients treated with CT (51 vs. 20 %, p = 0.01), platinum-based CT (70 vs. 47 %, p = 0.01) or palliative CT (61 vs. 39 %, p = 0.003). Anaemia was also more frequent in patients with more than three lines of CT (83 %) and in the fourth or subsequent CT cycle (58 %). Management in the previous 4 weeks in patients with anaemia was: 62 % did not receive treatment (92 % mild), 24 % received erythropoiesis-stimulating agents (ESAs), 14 % received iron and 8.7 % received transfusion.
In Spanish hospitals, about half of patients with non-myeloid malignancies undergoing systemic therapy fulfilled anaemia criteria (87 % mild). Approximately two-third of patients with anaemia do not receive specific treatment and ESA use is below current guidelines.
本研究旨在提供西班牙接受系统治疗的癌症患者贫血患病率和管理的最新数据。
这是一项于 2008 年进行的多中心、观察性、横断面研究。纳入标准为年龄≥18 岁、接受系统治疗(化疗、激素治疗或免疫治疗)的非髓性恶性肿瘤患者。贫血根据世界卫生组织的定义为血红蛋白(Hb)<12g/dL。
研究纳入 214 例患者,中位年龄为 63 岁(范围 20-91),58%为女性,73%为实体瘤患者,79%为晚期疾病患者。91%的患者接受化疗(26%使用铂类化合物),8.5%接受激素治疗,8.5%接受免疫治疗。在本研究中,48.1%的患者(95%置信区间 45.2-58.6)出现贫血(31%为症状性贫血):42.0%为轻度贫血(10≤Hb≤11.9g/dL),5.6%为中度贫血(8≤Hb≤9.9g/dL),0.5%为重度贫血(Hb<8g/dL)。接受化疗(51% vs. 20%,p=0.01)、铂类化疗(70% vs. 47%,p=0.01)或姑息性化疗(61% vs. 39%,p=0.003)的患者贫血患病率更高。接受超过三线化疗(83%)和第四或后续化疗周期(58%)的患者贫血更为常见。在过去 4 周内接受贫血管理的患者中:62%未接受治疗(92%为轻度贫血),24%接受了促红细胞生成素刺激剂(ESA)治疗,14%接受了铁剂治疗,8.7%接受了输血治疗。
在西班牙医院,约一半接受系统治疗的非髓性恶性肿瘤患者符合贫血标准(87%为轻度贫血)。约三分之二的贫血患者未接受特定治疗,ESA 的使用率低于当前指南。