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

• Published in: Medical journal of Australia Vol. 182; no. 9; pp. 453 - 457
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Sydney Australasian Medical Publishing Company 02-05-2005; Australasian Medical Publishing Company Proprietary, Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Anemia; Anemia - epidemiology; Anemia - etiology; Anemia - therapy; Anemias. Hemoglobinopathies; Australia - epidemiology; Biological and medical sciences; Breast cancer; Cancer therapies; Chemotherapy; Diseases of red blood cells; Female; General aspects; Gynecology; Hematologic and hematopoietic diseases; Hematologic diseases; Hematology; Hemoglobin; Humans; Incidence; Leukemia; Lymphoma; Male; Medical sciences; Middle Aged; Multiple myeloma; Neoplasms; Neoplasms - complications; Oncology; Patients; Prevalence; Prospective Studies; Radiation therapy; Regression analysis; Statistics, Nonparametric; Australia; Oceania; Human; Survey; Surveillance; Anemia; Adult; Patient; Hemopathy; Malignant tumor
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2005.tb06784.x

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.