FACTORS ASSOCIATED WITH INCREASED RED BLOOD CELLS TRANSFUSION REQUIREMENTS IN PATIENTS WITH HODGKIN AND NON-HODGKIN LYMPHOMA

Authors

  • Sheeraz Ali
  • Mussadique Ali
  • Farhana Badar
  • Abdul Basit
  • Abdul Hameed

Abstract

Background: Anaemia is a common feature of lympho-proliferative disorders and is an important cause of poor quality of life in these patients. When indicated, packed red blood cells (PRBC) units are transfused to treat anaemia. Objective of this study was to identify risk factors associated with PRBC transfusions in lymphoma patients. Methods: This was a retrospective study done on Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL) patients who had PRBC transfusions during chemotherapy. Information regarding gender, type of lymphoma, stage, baseline haemoglobin, marrow involvement and total number of PRBC units transfused was collected. Results: A total of 481 patients with diagnosis of HL and NHL were registered during one year period. Out of these, 108 (22.4%) had PRBC transfusions during treatment. HL and NHL patients were 30 (27.8%) and 78 (72.2%) respectively. NHL patients were older than HL (37 vs. 32 years), (p=0.03). HL patients had lower mean haemoglobin 9.3±2.56 g/dl as compared to NHL 11.33±2.42 g/dl, (p<0.05). There was significant difference in number of PRBC units transfused based on lymphoma type (NHL 6.74±5.69 vs. HL 3.97±3.0 units, p<0.05). Bone marrow involvement resulted in increased transfusion requirements (7.84±4.36 vs. 5.26±5.49 units, p<0.05) while stage of disease didn’t affected significantly (I/II-4.88±4.85 and III/IV 6.30±5.33 units p=0.2). Conclusion: A significant number of lymphoma patients need PRBC transfusions during chemotherapy. NHL patients and bone marrow involvement makes patients at higher risk for transfusions. In places, where blood bank support is not adequate, patients should be informed right from beginning to arrange donors for possible transfusions during chemotherapy.Keywords:  Anaemia, Haemoglobin, Lymphoma, Red blood cells, Transfusion

References

Tohda S. Overview of lymphoid neoplasms in the fourth edition of the WHO classification. Rinsho Byori 2012;60(6):560–4.

Shankland KR, Armitage JO, Hancock BW. Non-hodgkin lymphoma. Lancet 2012;380(9844):848–57.

Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: A systemic, quantitative review. Cancer 2001;91(12):2214–21.

Hong J, Woo HS, Kim H, Ahn HK, Sym SJ, Park J, et al. Anemia as a useful biomarker in patients with diffuse large B-cell lymphoma treated with rituximab-CHOP immunochemotherapy. Cancer Sci 2014;105(12);1569–75.

Moullet I, Salles G, Ketterer N, Dumontet C, Bouafia F, Neidhart-Berard EM, et al. Frequency and significance of anemia in non-hodgkin's lymphoma patients. Ann Oncol 1998;9(10):1109–15.

Coiffier B, Guastalla JP, Pujade-Lauraine E, Bastit P, Anemia Study Group. Anemia Study Group. Predicting cancer-associated anaemia in patients receiving non-platinum chemotherapy: Results of a retrospective survey. Eur J Cancer 2001;37(13):1617–23.

Mercadante S, Gebbia V, Marrazzo A, Filosto S. Anaemia in cancer: Pathophysiology and treatment. Cancer Treat Rev 2000;26(4):303–11.

Zucker S. The swinging pendulum of the anemia of cancer: Erythropoietin trumps hepcidin. J Clin Oncol 2011;29(2):e42.

Ferrario E, Ferrari L, Bidoli P, De Candis D, Del Vecchio M, De Dosso S, et al. Treatment of cancer-related anemia with epoetin alfa: A review. Cancer Treat Rev 2004;30(6):563–75.

Kadokura G, Katsumata N. Treatment of chemotherapy-induced anemia. Gan To Kagaku Ryoho 2014;41(4):416–20.

Cella D. Factors influencing quality of life in cancer patients: Anemia and fatigue. Semin Oncol 1998;25(3 Suppl 7):43–6.

Pettengell R, Silvestre AS, Schwenkglenks M, Rossi FG, Duehrsen U, Verhoef G, et al. Darbepoetin alfa administration in patients with non-hodgkin lymphoma and chemotherapy-induced anemia receiving (+/-R) CHOP. Hematology 2013;18(1):26–9.

Haioun C, Salar A, Pettengell R, Johnsen HE, Duehrsen U, Rossi FG, et al. Anemia and erythropoiesis-stimulating agent administration in patients with non-hodgkin lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone+rituximab chemotherapy: Results from an observational study. Leuk Lymphoma. 2011;52(5):796–803.

Athar S, Siddiqui N, Hameed A, Mahmood MT, Khan MZ. Impact of the follicular lymphoma international prognostic index risk categorization on survival of patients with follicular lymphoma in Pakistani population: A single centre experience. J Pak Med Assoc 2014;64(5):563–66.

Yi S, An G, Qi J, Zou D, Zhao Y, Zhang P, et al. The significance of bone marrow involvement in aggressive lymphomas: A retrospective comparison of clinical outcomes between peripheral T cell lymphoma and diffuse large B cell lymphoma in china. Acta Haematol 2010;124(4):239–44.

Tas F, Eralp Y, Basaran M, Sakar B, Alici S, Argon A, et al. Anemia in oncology practice: Relation to diseases and their therapies. Am J Clin Oncol 2002;25(4):371–9.

Cacic DL, Hervig T, Seghatchian J. Anemia treatment of lymphoproliferative malignancies with erypoiesis: An overview of state of the art. Transfus Apher Sci 2013;48(2):277–81.

Del Prete S, Cinieri S, Lorusso V, Maiorino L, Pizza C, Pisano A, et al. Impact of anemia management with EPO on psychologic distress in cancer patients: Results of a multicenter patient survey. Future Oncol 2014;10(1):69–78.

Downloads

Published

2015-03-01

Most read articles by the same author(s)

<< < 1 2 3 > >>