Abstract
Objective:Purpose of this study was to find out frequency of anemia and its causes in newly diagnosed treatment naive lymphoma patients.Methods:We retrospectively studied all lymphoma patients (> 18 years age) diagnosed and treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, from January 2016 till January 2017. The data was collected from electronic Hospital Information System. Descriptive statistics were done by using summary measures for categorical variables as well as continuous variables.Results:Out of a total 408 patients, 272 were males and 136 females. Median age of patients was 33 years (18-76). Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL) were the diagnosis in 201 and 134 patients respectively; rest of the patients had low grade lymphomas. Anemia was present in 184 (45%) patients. Anemia of chronic disease was the commonest cause of anemia and was present in 61 (33.1%) patients. Remaining patients had anemia secondary to marrow involvement 50(27.17%); iron deficiency anemia, Vitamin B-12 deficiency anemia and hemolytic anemia were the causes in 7.6, 1.6%, % and 0.54% respectively.Conclusion:Anemia is a common feature in newly diagnosed lymphoma patients with anemia of chronic disease as the commonest cause. It is more frequent in patients with higher stages of lymphoma especially when bone marrow is involved by lymphoma. Since anemia is an important adverse prognostic factor for the outcome of lymphoma patients, work up for anemia prior to initiation of chemotherapy should be done in every lymphoma patient in order to help improve the management of these patients.
Highlights
Lymphomas represent one of the commonest malignancies
There has been an increase in non hodgkin lymphoma (NHL) cases in past few decades and among B cell lymphomas diffuse large B cell lymphoma (DLBCL) is the commonest type.[1]
Anemia is commonly encountered in cancer patients; this problem is greater in lymphoma and multiple myeloma
Summary
Lymphomas represent one of the commonest malignancies. There has been an increase in non hodgkin lymphoma (NHL) cases in past few decades and among B cell lymphomas diffuse large B cell lymphoma (DLBCL) is the commonest type.[1] Anemia is frequently encountered in lymphoma patients and even observed before patients are started on chemotherapy and in the absence of bone marrow involvement.[2] It is a presenting feature in approximately 40% of patients with Hodgkin’s lymphoma (HL)[3] and is considered an important adverse prognostic factor for outcomes of therapy[4,5,6] especially in the background of bone marrow involvement which is yet another factor associated. It was further noted that those patients who were anemic even at six months after rituximab based therapy had higher risk for disease relapse.[8,9] In addition to its association with poor prognosis in cancer patients there is correlation between levels of hemoglobin and quality of life.[10]
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