Evaluation of anaemia in patients with multiple myeloma and lymphoma:: findings of the European CANCER ANAEMIA SURVEY
Evaluation of anaemia in patients with multiple myeloma and lymphoma:: findings of the European CANCER ANAEMIA SURVEY
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DOI：
10.1111/j.1600-0609.2006.00739.x
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发表时间：
2006-11-01
影响因子：
3.1
通讯作者：
Ludwig, Heinz
中科院分区：
文献类型：
--
作者：
Birgegard, Gunnar;Gascon, Pere;Ludwig, Heinz
目的：直到最近，还没有在欧洲癌症患者中进行淋巴瘤和多发性骨髓瘤（L/MM）的前瞻性流行病学调查;此外，关于L/MM的患病率、发病率和治疗模式的数据有限或不可用。在这里，我们定义了贫血的患病率，发病率和治疗模式，并确定欧洲L/MM患者贫血的危险因素。研究方法：分析了欧洲癌症贫血调查（ECAS）中2360例L/MM患者亚组的数据;变量包括年龄、性别、肿瘤类型/分期、癌症和贫血治疗、WHO体能状态和血红蛋白（Hb）水平。结果：2316例患者可评价（1612例L和704例MM）。入组时贫血率为52.5%。入组时Hb水平与WHO评分呈显著正相关（r =-0.306，P < 0.001）。ECAS期间贫血患病率为72.9%（MM，85.3%;非霍奇金淋巴瘤，77.9%;霍奇金病，57.4%）;化疗患者的发病率为55.4%。在ECAS期间任何时间，只有47.3%的贫血患者接受了贫血治疗;开始治疗时的总体Hb最低值为8.9 g/dL（依泊苷，9.5 g/dL;输血，8.2 g/dL）。发现贫血风险显著增加的因素（P < 0.03）是初始Hb低、女性、持续/耐药疾病和铂类化疗。结论：L/MM患者贫血的患病率和发生率很高;然而，贫血没有得到最佳治疗。贫血在L/MM患者中很常见，鉴于其对身体功能和生活质量变量（包括疲劳和认知功能）的已知不良影响，贫血管理应成为其护理的组成部分。ECAS确定的预测因素可能有助于临床医生为L/MM患者制定最佳的贫血治疗策略。
Objectives: Until recently, no prospective epidemiologic survey of lymphoma and multiple myeloma (L/MM) in European cancer patients had been conducted; furthermore, data on prevalence, incidence, and treatment patterns of L/MM were limited or unavailable. Here we define anemia prevalence, incidence, and treatment patterns, and identify anemia risk factors in European L/MM patients. Methods: Data for a subgroup of 2360 L/MM patients in the European Cancer Anaemia Survey (ECAS) were analyzed; variables included age, gender, tumor type/stage, cancer and anemia treatment, WHO performance status, and hemoglobin (Hb) levels. Results: 2316 patients were evaluable (1612 L and 704 MM). Anemia rate at enrollment was 52.5%. At enrollment, Hb levels correlated significantly with WHO scores (r = -0.306, P < 0.001). Anemia prevalence during ECAS was 72.9% (MM, 85.3%; non-Hodgkin's lymphoma, 77.9%; Hodgkin's disease, 57.4%); incidence in chemotherapy patients was 55.4%. Only 47.3% of patients anemic any time during ECAS received anemia treatment; overall Hb nadir for initiating treatment was 8.9 g/dL (epoetin, 9.5 g/dL; transfusion, 8.2 g/dL). Factors found to significantly (P < 0.03) increase anemia risk were low initial Hb, female gender, persistent/resistant disease, and platinum chemotherapy. Conclusions: L/MM patients have a high prevalence and incidence of anemia; however, anemia is not optimally treated. Anemia is common in L/MM patients and, given its known adverse impact on physical functioning and quality-of-life variables including fatigue and cognitive function, anemia management should be an integral part of their care. Predictive factors identified by ECAS may help clinicians develop optimal anemia treatment strategies for L/MM patients.