Anaemia in Cancer Patients Undergoing Radiotherapy and Chemotherapy at the National Hospital, Abuja

Abstract

Anaemia is one of the predisposing factors to poor patient outcome in cancer treatment. More than 50% of cancer patients will receive either Radiotherapy or Chemotherapy or both in the course of their treatment. It has been difficult to establish global or National benchmark on the baseline haemoglobin of patients selected for cancer therapy at different stages of the tumours. Various centers use different levels but there is a need to establish a national cut-off point. Establishing a uniform benchmark will inform a global best practice and increase the patient’s outcome and quality of life. The acceptable value of anaemia varies from centre to centre but Hb level of 10 g/dL in both male and female are usually acceptable in most Radiation Oncology Centers in Nigerian Hospitals. Haemoglobin level of 10 g/dL is a borderline value and administration of Radiotherapy or Chemotherapeutic agents however without adequate hematological support may tilt the patient into clinical anaemia. This prospective study was done to determine the pattern of anaemia in cancer patients undergoing Radiotherapy and Chemotherapy in Nigeria using 201 cancer patients enrolled in National Hospital Abuja with histopathologically confirmed malignancies (solid cancers). The prevalence of anaemia in the study was 63%. The impact of Chemotherapy on Hb level was more significant than in other treatment arms, hence Chemotherapy – 9.60-10.62 g/dL, Radiotherapy 11.52-12.13 g/dL, and Chemoradiation 10.98-11.36 g/dL. The HB level continually decreased in all arms of treatment. We recommend a benchmark of 11 g/dL minimum for any patient being selected for Radiotherapy, Chemotherapy and Chemoradiation in Nigeria.