Incidence of anemia in pediatric cancer patients in Europe: results of a large, international survey.
BACKGROUND
Anemia occurs frequently in children with cancer, but there is little information quantifying the incidence of anemia or treatment. A survey was conducted in 1998 in Europe by The Research Partnership with the objective of determining the incidence of anemia, identifying the hemoglobin triggers that initiated anemia treatment, and the current anemia treatment options available to clinicians.


METHODS
The survey was conducted in the 10 largest pediatric oncology centers each in France, Germany, Italy, Spain, and the UK, and in the 8 largest centers in both Belgium and The Netherlands. Telephone interviews with the most senior physician available in the institution were used to collect data, which included the numbers of patients treated or under follow-up, cancer types, and treatment practices for anemia.


RESULTS
Data were collected for 25,093 patients. Over 80% of patients were anemic (WHO: hemoglobin <or= 11 g/dL; EORTC: hemoglobin <or= 12 g/dL) regardless of tumor type; 97% of patients with leukemia, the most prevalent type of cancer (34% of the total population), were anemic. Decreases in hemoglobin levels to between 5.5 and 8.0 g/dL were the most common factor that precipitated anemia treatment. Treatment was almost exclusively blood transfusion; less than 5% of patients received drug treatment (which consisted mostly of folic acid or iron). Very few patients received recombinant human erythropoietin (rHuEPO, epoetin alfa) to treat anemia.


CONCLUSIONS
In general, clinicians were not able to give advantages or disadvantages of epoetin alfa as a treatment option for treating anemia in children with cancer, which reflects the limited knowledge of and experience with this agent.
Institut Curie, Pediatrie Oncologique, Paris, France. jean.michon@curie.net
Jean
J
Michon
D000293:Adolescent; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000150:complications; D011994:Recombinant Proteins
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa