[Anemia and neoadjuvant hormone therapy in radical surgery of localized cancer of the prostate].
BACKGROUND
Erythropoiesis is stimulated by androgens either through a direct action on bone marrow cells or through increased erythropoietin production. Androgen deprivation is a known cause for anaemia. The aim of this study was to evaluate the effect of neoadjuvant hormone therapy prior to radical surgery on haemoglobin (Hb) and haematocrit (Ht) levels in localised prostate cancer.


METHODS
47 patients with clinical localised prostate cancer were given LH-RH analogs plus flutamide for complete androgenic blockade (CAB) for at least 3 months prior to radical prostatectomy. A blood profile was obtained prior to start CAB and 3 months after therapy, and peri-operative transfusional requirements were evaluated. To assess any significant changes. Student's t test was used in the statistical analysis of paired data.


RESULTS
In our study all patients (100%) showed decreased Hb and Ht levels after 3 months on CAB. Mean decline for Hb was 1.9 g/dL (range 1.6-2.2) p:0.0001, and for Ht 5.8% (range 4.8-6.8) p:0.0001. Hb was lower than 12 g/dL in 10.6% patients after hormone therapy and anaemia results were normocytic-normochromic. 60% patients needed peri-operative blood transfusion, 2 units of packed cells on average.


CONCLUSIONS
Neoadjuvant CAB prior to radical prostatectomy results in a significant decline of Hb and Ht levels after 3 months treatment. Such decline may contribute to increase peri-operative transfusional requirements in a group of patients undergoing aggressive surgery which in itself involves a significant blood loss.
Arango Toro
O
O
Servicio y Cátedra de Urología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona.
Lorente Garín
J A
JA
Bielsa Gali
O
O
Griño Garreta
J
J
Gelabert Mas
A
A
D000726:Androgen Antagonists / Q000009:adverse effects*; D000740:Anemia / Q000139:chemically induced*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D005485:Flutamide / Q000009:adverse effects*; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects; D006801:Humans; D016729:Leuprolide / Q000009:adverse effects*; D008297:Male; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D017329:Triptorelin Pamoate / Q000009:adverse effects*
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D017329:Triptorelin Pamoate; D005485:Flutamide; D016729:Leuprolide