A prospective observational study of anaemia management in cancer patients - results from the German Cancer Anaemia Registry
- 5 October 2010
- journal article
- research article
- Published by Hindawi Limited in European Journal of Cancer Care
- Vol. 20 (4), 493-502
- https://doi.org/10.1111/j.1365-2354.2010.01230.x
Abstract
STEINMETZ T., TOTZKE U., SCHWEIGERT M., MITTERMÜLLER J., NAWKA S., TESCH H., GROSCHEK M., SÖLING U., HELLEBRAND E. & TSAMALOUKAS A. (2010) European Journal of Cancer CareA prospective observational study of anaemia management in cancer patients – results from the German Cancer Anaemia Registry The use of erythropoiesis‐stimulating agents (ESA) in cancer patients is still under debate. However, little is known about rationales, strategies, objectives, and effectiveness of anaemia treatments in common practice. The Cancer Anaemia Registry prospectively surveyed about 2000 cancer patients with anaemia throughout Germany. The main objectives of anaemia treatment regardless of modality were to improve quality of life (QOL) and to correct haemoglobin (Hb) levels. The Hb threshold for any anaemia treatment (means ± SD: 9.4 ± 1.2 g/dL) but not for blood transfusions (8.7 ± 1.0 g/dL) depended on cancer type and treatment strategy. Physicians preferred ESA as first‐line treatment to prevent transfusions in patients with solid tumours, if they thought that chemotherapy caused the anaemia. If they suspected other causes or patients had lymphoproliferative malignancies, physicians preferred transfusions or attempted to correct underlying disorders; both mainly to improve QOL or prognosis. Effectiveness of all strategies was comparable. However, ESA most effectively prevented transfusions; primary transfusions appeared less suitable for correcting Hb or improving QOL. Using supportive treatments for QOL improvement was common whereas diagnostic measures and intravenous iron therapy were underused. Prospective clinical trials using QOL as end point and evaluating diagnostics in cancer‐associated anaemia are warranted.Keywords
This publication has 29 references indexed in Scilit:
- Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomesBritish Journal of Cancer, 2010
- Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables: results from the Anemia Cancer Treatment (ACT) studyAnnals of Oncology, 2009
- EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 updateEuropean Journal Of Cancer, 2007
- Evaluation of anaemia in patients with multiple myeloma and lymphoma: findings of the European CANCER ANAEMIA SURVEYEuropean Journal of Haematology, 2006
- Management of Cancer-Related Anemia in Patients with Breast or Gynecologic Cancer: New Insights Based on Results from the European Cancer Anemia SurveyThe Oncologist, 2005
- EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancerEuropean Journal Of Cancer, 2004
- Intravenous Iron Optimizes the Response to Recombinant Human Erythropoietin in Cancer Patients With Chemotherapy-Related Anemia: A Multicenter, Open-Label, Randomized TrialJournal of Clinical Oncology, 2004
- Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trialThe Lancet, 2003
- Anemia is associated with lower local-regional control and survival after radiation therapy for head and neck cancer: a prospective study.Radiology, 1996
- A practical approach to the differential diagnosis and evaluation of the adult patient with macrocytic anemiaMedical Clinics of North America, 1992