Frequency of blood transfusions for anemia due to chemotherapy in ovarian cancer patients. Thoughts to the guidelines modified in 2006 for the treatment of anemic cancer patients by the European Organisation for Research and Treatment of Cancer

Abstract

The European Organisation for Research and Treatment of Cancer distributed the modified guidelines for blood transfusions and erythropoietic drugs in the treatment of cancer anemia in the year 2006. According to this document the blood transfusions are indicated at the level of 9 g/dL of hemoglobin. Up to this year a definitive limit for applying blood transfusion in chemotherapy-induced anemia has not been determined in Hungary. The authors evaluated their practice in the treatment of anemia with blood transfusions in ovarian cancer patients treated in 2005. In lack of international or domestic guidelines, considering also the clinical status of the patients, the authors applied blood transfusions at a hemoglobin level of 10 g/dL. 190 epithelial ovarian cancer patients were given chemotherapy in the Gynecological Department at the National Institute of Oncology, Hungary. Selected for the patient packed red blood cell transfusion was administered if the hemoglobin has fallen below 10 g/dL, and together with it most patients (51/64 = 79,6%) were given erythropoietic drugs as well. Blood transfusion was given in 64 of 190 (34%) chemotherapies patients and almost the half of these latter patients (34/64 = 53%) were transfused more than once. In 86% of patients blood transfusion was given for G2 anemia. The largest rate (16/16) of blood transfusions according to the different types of chemotherapy was done in patients receiving combined therapy with gemcitabine and carboplatin. Chemotherapy for ovarian cancer causes severe anemia (hemoglobin level < 10 g/dL) in one third of patients. Besides blood transfusions, physicians have to pay attention to the necessity of erythropoietic drugs, as well.