Evidence Suggests That Correcting Anemia May Prolong Survival in Cancer Patients

Evidence Suggests That Correcting Anemia May Prolong Survival in Cancer Patients

LOS ANGELES—Preclinical and early clinical evidence indicates that
correcting anemia might prolong survival in cancer patients, reported John
Glaspy, MD, MPH, at the Fifth Quality of Life in Oncology Symposium in
Pasadena, California. He called for more prospective randomized trials
specifically designed to investigate the effect of anemia on survival.

Dr. Glaspy is medical director of the Boyer Oncology Clinic and professor
of medicine at the University of California School of Medicine in Los
Angeles. He served as co-chair of the symposium, which was supported by an
unrestricted educational grant from Amgen.

"In cancer patients, anemia might contribute to disease progression
by decreasing the efficacy of radiation therapy, by impacting the biology of
cancer to favor a higher virulence, and by decreasing the functional status
of our patients so that they don’t receive optimal treatment," he

A Newer Model

The newer model of the anemia of chronic disease contrasts with the
traditional model in two very important ways—by proposing a correlation
between the degree of anemia and the severity of disease and predicting that
specific treatment of anemia might alter the course of disease. "This
has obvious implications for the importance of treatment," Dr. Glaspy

In a study of rats with induced anemia, researchers looked into which
cytokines mediate the anemia of chronic disease and found "an exuberant
IL-1 and TNF response on the part of inflammatory cells," Dr. Glaspy
said. In one arm of the study, anemic rats treated with darbepoetin alfa
(Aranesp) had an inflammatory reaction of macrophages that was close to the
control group. "This is one piece of a very large body of evidence that
the anemia of chronic disease may contribute to the inflammatory milieu that
results in a downhill spiral," Dr. Glaspy said.

A literature search would reveal an emerging body of epidemiology
evidence that the anemias of chronic diseases are predictive of poor
outcomes for those diseases, Dr. Glaspy said. These diseases include
inflammatory bowel disease, liver disease, rheumatoid arthritis, systemic
lupus erythematosus, HIV, congestive heart failure, and several types of
cancer. This suggests that anemia may simply be a marker for the severity of
disease or a contributing factor to the outcome.


Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.