title: Correlation between anemia and functional/cognitive capacity in elderly lung cancer patients treated with chemotherapy.
abstract: BACKGROUND
  Elderly cancer patients are often excluded from clinical trials and no data are available on the impact of chemotherapy-related anemia on their functional status and cognitive functions. This observational study investigates the association between hemoglobin (Hb) level and comprehensive geriatric assessment (CGA) variables (MMSE, ADL/IADL, GDS, CIRS and VAS).
  
  
  METHODS
  We enrolled 42 consecutive lung cancer elderly patients undergoing chemotherapy that were evaluated at baseline and after each CT cycle at least until cycle 2. Hb association with CGA indexes was expressed using Spearman's non-parametric coefficient r.
  
  
  RESULTS
  Higher Hb values were significantly associated with more favourable values of all indexes measuring mental and functional capacity, depression and comorbidities. For all indexes except IADL, improvements from baseline were significantly related with concomitant Hb increases. In 14 patients given erythropoietin during the first two cycles, mean Hb increased from 9.2 to 10.8 g/dl, and the mean values of all CGA indexes were improved. On the contrary, in 18 patients not given erythropoietin, Hb varied from 13.0 to 11.2 g/dl and a parallel worsening in all CGA indexes was observed.
  
  
  CONCLUSIONS
  Chemotherapy-related anemia is associated with impairment of functional status and cognitive functions. In elderly cancer patients anemia correction or maintenance could be useful to preserve functional independency and protect from mental decay. However, the study results need to be confirmed on a larger series of patients within a controlled clinical trial.
authors.affiliation: 5th Pneumo-Oncology Unit, Department of Lung Diseases, S. Camillo-Forlanini Hospital, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mancuso
authors.forename: M
authors.initials: M
authors.lastname: Migliorino
authors.forename: S
authors.initials: S
authors.lastname: De Santis
authors.forename: A
authors.initials: A
authors.lastname: Saponiero
authors.forename: F
authors.initials: F
authors.lastname: De Marinis
mesh_terms: D000368:Aged; D000740:Anemia / Q000139:chemically induced*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology; D003072:Cognition Disorders / Q000139:chemically induced*; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D008297:Male; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins