Anemia, renal disease, and chemotherapy in the IRMA study

Abstract

20649 Background: Both anticancer drugs and kidney disease (KD) may induce anemia. In this analysis, we studied hemoglobin (Hb) levels of the pts in parallel with their renal function (RF) and their anticancer drugs. Methods: From IRMA data, the frequency of anemia was evaluated as defined by the WHO, and according to its severity (11 to 9 and <9 g/dL), with regards to the treatment. We then studied the frequency of KD (aMDRD<60) in anemic vs non-anemic pts, for each treatment. Results: Table 1 shows the frequency of anemia and the frequency of KD in patients with and without anemia, for each treatment. Conclusions: Anemia and aMDRD<90 were highly frequent. In some anticancer protocols, the frequency of aMDRD <60 was higher in anemic patients as compared to non-anemic patients (Taxanes x1.5), FOLFIRI (x3.9), and Trastuzumab (x4.6)). For this level of RF, renal anemia is a frequent complication of KD and may participate in the decreased Hb levels observed in our patients in addition to drug toxicity. Table 1. Anticancer Protocol (N) Anemia Yes/No (% of pts) Anemia (g/dL) (% of pts) aMDRD (mL/min/1.73 m2) (% of pts) 11 to 9 < 9 < 90 < 60 CEF (451) Y: 40.6% N: 56.5% 15.3% - 0.4% - 44.8% 45.9% 3.3% 3.5% Taxanes (418) Y: 60.0% N: 37.6% 23% - 4.8% - 50.2% 45.2% 11.6% 7.6% FOLFOX (190) Y: 52.6% N: 37.4%% 14.2% - 2.1% - 50.0% 63.4% 8.0% 5.6% FOLFIRI (171) Y: 56.1% N: 36.8% 19.3% - 1.2% - 55.2% 60.3% 18.8% 4.8% Carboplatin + Paclitaxel (130) Y: 63.8% N: 34.6% 23.8% - 3.8% - 60.2% 71.1% 19.3% 17.8% Vinorelbine (110) Y: 67.3% N: 25.5% 30% 3.6% 46.0% 57.1% 9.5% 7.1% Trastuzumab (123) Y: 30.9% N: 61.0% 8.1% - 5.3% - 47.4% 64.0% 18.4% 4.0% Hb: Hemoglobin; WHO Definition of anemia: <12 g/dL in women and <13 g/dL in men; CEF: Cyclophosphamide + Epirubicin + Fluorouracil; Taxanes: Paclitaxel or Docetaxel; FOLFOX: Folinic acid + Fluorouracil + Oxaliplatin; FOLFIRI: Folinic acid + Fluorouracile + Irinotecan No significant financial relationships to disclose.