Guidelines for Complications of Cancer Treatment Vol VIII Part B

Anemia and Cancer – incidence, etiology andpathogenesisAnemia is common both at baseline and develops increasinglywhile on treatment. The European Cancer Anemia Survey(ECAS) cited 50% baseline anemia rate (Hemoglobin < 12 g/dL) among patients with hematological malignancies, and a41% baseline anemia rate amongst solid tumors patients [1] . Alongitudinal analysis further revealed that 72% of patients withhematological malignancies and 66% of patients with solidtumors became anemic at some point during the course oftheir treatment. [1] Groopman and Itri reported that the mostsignificant rates of anemia requiring transfusion existed inpatients with lung, gynecologic, and genitourinary tumors, withthe incidence ranging from 50% to 60%. [2]Type of CancerPrevalence of Anemia(Hemoglobin < 12 g/dL)Hematologic malignancies [1] 72%Solid tumors [1] 66%Colorectal cancer [3] 67%Lung cancer [3] 63%Cervical cancer [3] 82%A number of factors contribute to the high incidence of cancerrelatedanemia and these include:1. Chemotherapy and radiation-induced myelosuppression,2. Bleeding and hemolysis3. Marrow infiltration by tumor,4. Nutritional deficiencies5. Cytokine-mediated anemia of chronic disease.The pathogenesis of chronic anemia in cancer results from aninteraction between the tumor cells and the host’s own immune478