Hemoglobin variation and blood transfusion rates in patients affected by locally advanced cervical cancer undergoing neo-adjuvant chemotherapy followed by radical surgery: the role of erythropoietic growth factors

• Published in: Annals of oncology Vol. 18; no. 4; pp. 722 - 729
• Main Authors: Bellati, F, Pernice, M, Manci, N, Palaia, I, Tomao, F, Marchetti, C, Zullo, MA, Muzii, L, Angioli, R, Panici, P. Benedeth
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2007; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Anemia - therapy; Antineoplastic agents; Biological and medical sciences; Blood Transfusion - statistics & numerical data; blood transfusions; Cervical cancer; Chemotherapy, Adjuvant; erythropoietic growth factors; Erythropoietin - therapeutic use; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Hemoglobins - analysis; Humans; locally advanced cervical cancer; Medical sciences; Middle Aged; neo-adjuvant chemotherapy; Neoadjuvant Therapy; Pharmacology. Drug treatments; Tumors; Uterine Cervical Neoplasms - blood; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - therapy; Erythropoiesis; Human; Biological fluid; Transfusion; blood transfusions; erythropoietic growth factors; Adjuvant treatment; Malignant tumor; Uterine cervix; locally advanced cervical cancer; Blood; Female genital diseases; Chemotherapy; Surgery; Hemoglobin; Advanced stage; neo-adjuvant chemotherapy; Uterine cervix diseases; Cervical cancer; Growth factor
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdl491

Background: The objectives of the present study were to evaluate hemoglobin levels and consequent clinical behaviors related to anemia developed in patients affected by locally advanced cervical cancer treated with neo-adjuvant chemotherapy in the last decade and to evaluate the impact that the introduction of erythropoietic growth factors had in the clinical practice. Patients and methods: Blood chemistries, prospectively recorded from 98 cervical cancer patients, treated with neo-adjuvant chemotherapy and, if necessary, erythropoietic growth factors, were compared with matched historical controls before the introduction of growth factors in clinical practice. Results: Hemoglobin level in the study group did not differ significantly during chemotherapy. At the third cycle of chemotherapy and at the end of chemotherapy, hemoglobin level was significantly higher in the study group compared with the control group. Transfusion rates in the study group were significantly lower. The analysis within the study group revealed that hemoglobin level in patients who suffer at diagnosis from anemia tends to increase whereas hemoglobin level in nonanemic patients tends to decrease. Conclusions: Erythropoietic growth factors increase hemoglobin level and reduce blood transfusions in cervical cancer patients undergoing neo-adjuvant chemotherapy followed by radical surgery. An appropriate autologous blood donation program can noticeably reduce homologous blood transfusions.