This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ray-Coquard, I. Articles by Blay, J. Y. Search for Related Content PubMed PubMed Citation Articles by Ray-Coquard, I. Articles by Blay, J. Y. Social Bookmarking                            What's this?

Risk Model for Severe Anemia Requiring Red Blood Cell Transfusion After Cytotoxic Conventional Chemotherapy Regimens

From the Centre Léon Bérard, Lyon; Institut G. Roussy, Villejuif; Centre Hospitalier, Chambéry; Centre R. Gauducheau, Nantes; Fondation Bergonié, Bordeaux; and Centre. Cl. Regaud, Toulouse, France.

Address reprint requests to J-Y Blay, MD, PhD, Centre Léon Bérard, 28, rue Laënnec-69008 Lyon, France; email blay{at}lyon.fnclcc.fr

PURPOSE: Cancer patients frequently experience anemia as a consequence of myelosuppressive therapy or bone marrow invasion.

PATIENTS AND METHODS: A risk model for chemotherapy-induced severe anemia requiring RBC transfusions (SARRT) within 31 days after the administration of chemotherapy was delineated in the cohort of cancer patients treated with chemotherapy in the Department of Medicine of Centre Léon Bérard in 1996 (CLB-1996). The risk model was tested on a series of 797 patients treated in 1997 (CLB-1997) and on 295 patients included in a multicenter prospective series (ELYPSE 1).

RESULTS: One hundred seven of the 1,051 patients of the CLB-1996 cohort (10%) experienced SARRT. In univariate analysis, only female sex, performance status greater than 1, hemoglobin level less than 12 g/dL before chemotherapy on day 1 (d1), and d1 lymphocyte count 700/µL significantly correlated with the risk of SARRT. Using logistic regression, d1 hemoglobin level less than 12 g/dL (odds ratio [OR] = 14.0; 95% confidence interval [CI], 7 to 30), performance status greater than 1 (OR = 2.2; 95% CI, 1.4 to 3.5), and d1 lymphocyte count 700/µL (OR = 1.7; 95% CI, 1.1 to 2.6) were identified as independent risk factors for SARRT. These three factors were given arbitrary risk coefficients of 3, 1, and 1 respectively, and a risk score for each individual patient was obtained by adding the coefficients. The calculated probability of RBC transfusions was 30% for patients with a score 4, and 11%, 4%, and 1% in patients with a score of 2 or 3, 1, and 0 respectively. This model was then tested and validated in the CLB-1997 and ELYPSE 1 series.

CONCLUSION: This risk index could be useful to identify patients at high risk for chemotherapy-induced SARRT who might be appropriate candidates for prophylactic erythropoietin treatment.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Aapro, H. Ludwig, C. Bokemeyer, K. MacDonald, P. Soubeyran, M. Turner, T. Albrecht, and I. Abraham Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables: results from the Anemia Cancer Treatment (ACT) study Ann. Onc., October 1, 2009; 20(10): 1714 - 1721. [Abstract] [Full Text] [PDF]

				I. Ray-Coquard, C. Cropet, M. Van Glabbeke, C. Sebban, A. Le Cesne, I. Judson, O. Tredan, J. Verweij, P. Biron, I. Labidi, et al. Lymphopenia as a Prognostic Factor for Overall Survival in Advanced Carcinomas, Sarcomas, and Lymphomas Cancer Res., July 1, 2009; 69(13): 5383 - 5391. [Abstract] [Full Text] [PDF]

				I. Ray-Coquard, S. Dussart, C. Goillot, D. Mayeur, P. Debourdeau, H. Ghesquieres, T. Bachelot, A. Le Cesne, B. Anglaret, C. Agostini, et al. A risk model for severe anemia to select cancer patients for primary prophylaxis with epoetin {alpha}: a prospective randomized controlled trial of the ELYPSE study group Ann. Onc., June 1, 2009; 20(6): 1105 - 1112. [Abstract] [Full Text] [PDF]

				M. Ziepert, R. Schmits, L. Trumper, M. Pfreundschuh, M. Loeffler, and On behalf of the German High-Grade Non-Hodgkin's L Prognostic factors for hematotoxicity of chemotherapy in aggressive non-Hodgkin's lymphoma Ann. Onc., April 1, 2008; 19(4): 752 - 762. [Abstract] [Full Text] [PDF]

				P. Marec-Berard, J. Y. Blay, M. Schell, M. Buclon, C. Demaret, and I. Ray-Coquard Risk Model Predictive of Severe Anemia Requiring RBC Transfusion After Chemotherapy in Pediatric Solid Tumor Patients J. Clin. Oncol., November 15, 2003; 21(22): 4235 - 4238. [Abstract] [Full Text] [PDF]

				J. Alexandre, M. Gross-Goupil, B. Falissard, M.-L. Nguyen, J.-M. Gornet, J.-L. Misset, and F. Goldwasser Evaluation of the nutritional and inflammatory status in cancer patients for the risk assessment of severe haematological toxicity following chemotherapy Ann. Onc., January 1, 2003; 14(1): 36 - 41. [Abstract] [Full Text] [PDF]

				V. Caggiano, R. E. Tannous, S. Gupta, and M. Fridman Chemotherapy-induced moderate to severe anemia in intermediate-grade non-Hodgkin's lymphoma patients Journal of Oncology Pharmacy Practice, June 1, 2002; 8(2-3): 73 - 80. [Abstract] [PDF]

				V. Caggiano, S. Gupta, R. E Tannous, M. Fridman, and W. B Carter Chemotherapy-induced moderate tolife-threatening anemia in early-stage breast cancer Journal of Oncology Pharmacy Practice, December 1, 2001; 7(4): 127 - 132. [Abstract] [PDF]

				G. Dranitsaris The cost of blood transfusions in cancer patients: a reanalysis of a Canadian economic evaluation Journal of Oncology Pharmacy Practice, June 1, 2000; 6(2): 37 - 42. [Abstract] [PDF]