Anaemia in hospitalized cancer patients: a retrospective study of two cohorts before and after the 2010 guideline update

Abstract

Abstract Purpose The incidence of anemia and its consequences are often underestimated during cancer management. Recommendations were updated in 2010. Methods In this single-centre retrospective study, we assessed patient management before and after the publication of these recommendations. Eligible patients were treated for cancer and warranted overnight hospitalization over two periods (n = 206 in 2011, n = 143 in 2018). The diagnosis of anaemia was defined by a haemoglobin level below 12 and 13 g/dl for women and men, respectively. Results The prevalence of anaemia was 26% in 2011 and 16% in 2018 (p < .001). Biological assessment had changed between the two periods, with more tests of iron metabolism and measurements of inflammatory parameters. Patients hospitalized in 2018 had more advanced cancer and more severe anaemia. Rate of transfusion therapy did not change, but patients with mild and moderate anaemia were transfused less in 2018. Intravenous iron and erythropoietin-stimulating agent were used more frequently in 2018, mainly for mild anaemia and life-threatening anaemia, respectively. Overall survival was poor in both cohorts at 24 months after anaemia diagnosis (15.4% in 2011 and 6.5% in 2018, p = .048). Conclusion Practices have changed in the diagnosis of anaemia and prescriptions for erythropoietin-stimulating agents and intravenous iron have increased. Efforts must continue to explore the causes of anaemia, optimize the quality of life of anaemic patients and reduce transfusions.