Risk model for severe anemia in patients with non-hematologic cancer receiving conventional chemotherapy: Results from a multicenter prospective cohort study

Abstract

8121 Background: Identification of clinical baseline characteristics that correlate with anemia development could optimize patient care and anemia management. Methods: A risk index for severe anemia, defined as Hb < 8 g/dL or poorly tolerated anemia < 10 g/dL that requires red blood cell transfusion (RBCT), was delineated in a prospective cohort of patients with non hematologic cancer treated with CT ± RT. Data about pts demographics, clinical and tumor characteristics, laboratory parameters and CT agents were collected just before the administration of each course of CT. Risk factors for Severe Anemia (SA) were tested in univariate and multivariate analyses using a logistic regression. A risk model was established using the independent risk factors identified in the multivariate analysis. A total of 450 pts (56% male) were included, 30% had anemia and 64.2% received rHuEPO. Results: Thirty six pts (8%) experienced SA. In multivariate analysis, only the presence of metastases (odds ratio [OR]= 2.8; 95% confidence interval [CI] 1.2 - 7.1), height (OR= 1.1; 95% CI 1.03 - 1.14), number of previous RBCT (OR= 2.1; 95% CI 1.2 - 3.7), baseline Hb level (OR= 0.55; 95% CI 0.39 - 0.77), concomitant RT (OR= 7.25; 95% CI 2.5 - 20.7), and increase platelet count (OR= 1.003; 95% CI 1 - 1.006) and Hb level (OR= 0.46; 95% CI 0.3 - 0.7) after first course of CT were independent risk factors for SA. For these 7 factors, risk coefficients were assigned depending on the value of their OR, and a risk score for each individual patient was obtained by adding the coefficients. The calculated probability of SA was 0%, < 25%, 25–50%, 50–85% and > 85% for patients with a score 0–3, 3–6, 7–8, 9–10 and > 10, respectively. Conclusions: This risk index could be useful to identify patients at high risk for CT-induced SA who might be appropriate candidates for prophylactic rHuEPO treatment. No significant financial relationships to disclose.