title: 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.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Gynecology, Obstetrics and Perinatology, University of Rome La Sapienza, Viale Regina Elena 324, 00161 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bellati
authors.forename: M
authors.initials: M
authors.lastname: Pernice
authors.forename: N
authors.initials: N
authors.lastname: Manci
authors.forename: I
authors.initials: I
authors.lastname: Palaia
authors.forename: F
authors.initials: F
authors.lastname: Tomao
authors.forename: C
authors.initials: C
authors.lastname: Marchetti
authors.forename: M A
authors.initials: MA
authors.lastname: Zullo
authors.forename: L
authors.initials: L
authors.lastname: Muzii
authors.forename: R
authors.initials: R
authors.lastname: Angioli
authors.forename: P
authors.initials: P
authors.lastname: Benedeth Panici
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000628:therapy*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000150:complications* / Q000628:therapy
chemical_list: D006454:Hemoglobins; D004921:Erythropoietin