Study of anemia in non-luminal solid tumors

Nupoor Dandavate; Nitin Gadkari; Ashwin Rajbhoj; Mayur Patil; Naineesh Gaikwad; Ashwin Bankar

doi:10.18203/2349-3933.ijam20231878

Authors

Nupoor Dandavate Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India
Nitin Gadkari Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India
Ashwin Rajbhoj Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India
Mayur Patil Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India
Naineesh Gaikwad Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India
Ashwin Bankar Department of Medicine, Bharati Hospital and Research Center, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20231878

Keywords:

Anemia, Solid tumors, Cancer

Abstract

Background: Anemia is particularly prevalent in India due to widespread malnutrition. Cancer related anemia affects about three-fourths of cancer patients, causing symptoms like fatigue, appetite loss, and difficulty concentrating, and can worsen cancer prognosis, lengthen treatment, and reduce survival rates. Anemia is a significant cause of tumor hypoxia, which exacerbates the side effects of radiotherapy and chemotherapy, and affects energy levels and emotional distress.

Methods: The present cross-sectional study aims to assess the prevalence and types of anemia in patients with newly diagnosed non-luminal solid tumors. The study sample included all patients meeting the inclusion criteria, with a sample size of 100. Clinical evaluation and investigations were carried out to determine the presence and severity of anemia. Data was compiled and analyzed.

Results: Of the 100 patients enrolled, 68% had evidence of anemia, and the majority of them were in the age group of 51-60 years. Anemia’s association with body mass index (BMI) was noted and was more common in underweight and normal-weight patients. The commonest malignancies in the study were head and neck cancers, breast cancers and female genital cancers, and the incidence of anemia in these malignancies was higher than in other tumors. When sub-classified a higher prevalence in gynecological tumors was noted. The majority of anemic patients had mild anemia, with microcytic hypochromic anemia being the most common type.

Conclusions: The study provides valuable information on the incidence and severity of anemia in patients with non-luminal solid tumors, which can help clinicians in their treatment planning and management.

Metrics

Metrics Loading ...

References

Marks PW, Rosenthal, DS. Hematologic manifestations of systemic disease: infection, chronic inflammation, and cancer. In: Hoffman R, Benz EJ, Shattil SJ, editors. Hematology: Basic Principles and Practice. 5th edition. Philadelphia, PA: Churchill Livingstone Elsevier. 2009;2309-19.

Ludwig H, Van Belle S, Barrett-Lee P, Birgegård G, Bokemeyer C, Gascón P, et al. The European Cancer Anemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anemia in cancer patient. Eur J Cancer. 2004;40:2293-306.

Rodgers GM, Becker PS, Blinder M, Cella D, Chanan-Khan A, Cleeland C, et al. Cancer- and chemotherapy-induced anemia. Journal of the National Comprehensive Cancer Network. JNCCN. 2012;10(5):628-53.

Kanuri G, Sawhney R, Varghese J, Britto M, Shet A. Iron Deficiency Anemia Coexists with Cancer Related Anemia and Adversely Impacts Quality of Life. PLoS One. 2016;11(9):e0163817.

Guyton AC, Hall JE. Red blood cells, anemia, and polycythemia. In: Guyton AC, Hall JE, eds. Textbook of Medical Physiology. 11th edition. Philadelphia, PA: Elsevier Saunders. 2006;419-28.

Morceau F, Dicato M, Diederich M. Pro-inflammatory cytokine-mediated anemia: regarding molecular mechanisms of erythropoiesis. Mediators Inflamm. 2009;405016.

Bridges KR, Pearson HA. Cancer and anemia. In: Bridges KR, Pearson HA, eds. Anemias and Other Red Cell Disorders. New York, NY: McGraw-Hill Medical Publishing Division. 2008;58-80.

Kifle E, Hussein M, Alemu J, Tigeneh W. Prevalence of Anemia and Associated Factors among Newly Diagnosed Patients with Solid Malignancy at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia. Adv Hematol. 2019;8279789.

Varlotto J, Stevenson MA. Anemia, tumor hypoxemia, and the cancer patient. Int J Radiat Oncol Biol Phys. 2005;63:25-36.

Tas F, Eralp Y, Basaran M, Sakar B, Alici S, Argon A, et al. Anemia in oncology practice: relation to diseases and their thera- pies. Am J Clin Oncol. 2002;25:371.

Chowdhary GS, Kishore K, Bagga G. Prevalence of anemia in patients with solid tumors: a single center cross-sectional study at a tertiary care center in west India. Int J Sci Res. 2020;9(1):45-7.

Muthanna FMS, Karuppannan M, Abdulrahman E, Uitrakul S, Rasool BAH, Mohammed AH. Prevalence and Associated Factors of Anemia among Breast Cancer Patients Undergoing Chemotherapy: A Prospective Study. Adv Pharmacol Pharm Sci. 2022;7611733.

Muthanna FMS, Hassan BAR, Karuppannan M, Mohammed AH. Evaluation of the impact of anaemia on quality of life among breast cancer patients undergoing chemotherapy in Malaysia. J Pharm Health Services Res. 2021;12(2):310-2.

Littlewood TJ. The impact of hemoglobin levels on treatment outcomes in patients with cancer. Semin Oncol. 2001;28(8):49-53.

Coiffier B, Guastalla JP, Pujade-Lauraine E, Bastit P. Predicting cancer-associated anaemia in patients receiving non-platinum chemotherapy: results of a retrospective survey. Eur J Cancer. 2001;37:1617-23.

Madeddu C, Gramignano G, Astara G, Demontis R, Sanna E, Atzeni V, et al. Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach. Front Physiol. 2018;9:1294.

Harper P, Littlewood T. Anemia of cancer: impact on patient fatigue and long-term outcome. Oncology. 2005;69:S2-7.

Han SV, Park M, Kwon YM, Yoon HJ, Chang Y, Kim H, et al. Mild anemia and risk for all-cause, cardiovascular and cancer deaths in apparently healthy elderly Koreans. Korean J Fam Med. 2019;40(3):151-8.

Xu H, Xu L, Page J, Cannavale K, Sattayapiwat O, Rodriguez R, et al. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013. Clin Epidemiol. 2016;8:61-71.

Ludwig H, Müldür E, Endler G, Hübl W. Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia. Ann Oncol. 2013;24(7):1886-92.

Almehmadi M, Salih M, Elmissbah TE, Alsharif A, Alsiwiehri N, Alzahrani K, et al. Prevalence of anemia among Saudi patients with solid cancers at diagnosis in King Faisal Hospital, Taif Province, Kingdom of Saudi Arabia. PLoS One. 2021;16(1):e0246202.

Schwartz RN. Anemia in patients with cancer: incidence, causes, impact, management, and use of treatment guidelines and protocols. Am J Health Syst Pharm. 2007;64(3):S5-13.

Birgegård G, Aapro MS, Bokemeyer C, Dicato M, Drings P, Hornedo J, et al. Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology. 2005;68(1):3-11.

Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: A systematic review of the literature. Am J Med. 2004;116:11-26.