Abstract
8091 Background: A significant proportion of cancer patients receiving chemotherapy will present with or develop anemia. The cause of this anemia is often the inflammatory cytokine-mediated anemia of chronic disease associated with cancer and/or chemotherapy. We are currently performing a trial in anemic cancer patients on chemotherapy being treated with EPO to see if no iron, oral iron, or iv iron improves the Hb response. While this trial is still ongoing, we report here the initial anemia screening parameters for all patients considered for study. Methods: After giving informed consent, patients starting a cycle of chemotherapy were screened. Samples were sent to a central laboratory for screening if a recent Hb was <11g/dL, the pt was eligible for EPO therapy, and had not been treated with EPO during the preceding 30 days. Results: Of 261 patients screened (174 female), overall 44 pts (17%) had ferritin <100ng/mL, and 154 pts (59%) had transferrin (TSAT) < 20%. Among pts with ferritin <100ng/ml, 77% also had TSAT < 20%. While 216 pts (83%) had ferritin >100ng/mL, 120 of these (46% of all pts) also had TSAT <20%. Seventy pts (27%) had content of reticulocyte hemoglobin (CHR) < 32 g/dL. No pts had red blood cell folate < 93ng/mL. Of 5 pts with low B12, only one had elevated MCV. Conclusions: Our results indicate a surprising prevalence of B12 and/or Iron deficiency in anemic cancer patients presenting for EPO therapy. Possible iron deficiency was indicated by either TSAT <20 % (which may coexist with an elevated ferritin), ferritin of < 100ng/ml and/or CHR < 32 g/dL. A small but significant proportion of anemic cancer pts presenting for EPO therapy may have B12 or iron deficiency. A basic work up to rule out treatable causes of anemia such as B12 or iron deficiency should be performed. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Watson Laboratories Watson Pharma
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