The impact of anemia on quality of life and hospitalisation in elderly cancer patients undergoing chemotherapy.
OBJECTIVE
at present, there is very little data available about the impact of anemia on elderly cancer patient's quality of life (QoL). Most of the acquired knowledge has been derived from small studies selected for primary site cancer. This observational study investigates the association between hemoglobin (Hb) level and comprehensive geriatric assessment variables: Cancer Linear Analog Scale (CLAS), Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE) in elderly cancer patients undergoing chemotherapy (CT).


METHODS
we enrolled 586 elderly cancer patients undergoing CT who were evaluated at baseline and every 3-4 weeks for at least 12 weeks. The correlation between Hb level changes and the examined index changes were performed using Pearson correlation analysis and a multivariate analysis was performed using a logistic regression model.


RESULTS
both univariate and multivariate analyses at baseline showed that Hb values are related to ECOG performance status (PS), stage of disease and self-reported QoL. Hb level variation significantly correlated with CLAS and ADL changes measured at baseline and after 12 weeks. This correlation is highly significant in patients with Hb< 11g/dl. Multivariate analysis showed that Hb change of at least 1g/dl was the only independent predictor of a better quality of life, when assessed by using the CLAS and ADL questionnaire (p<0.05). Moreover the median time of hospitalisation was found to be significantly lower in patients showing higher Hb level (Hb ≥ 11g/dl) (p=0.037).


CONCLUSIONS
the findings of this study seem to provide adequate support for the correlation between anemia and elderly cancer patient's QoL. Interestingly, we reported an association between anemia and the length of hospitalisation in this setting of patients. However, the above results do need to be confirmed by further prospective trials.
Doni
Laura
L
Medical Oncology Unit, AOU Careggi Hospital, Viale Pieraccini n. 17, 50139 Firenze, FI, Italy. doni.laura@gmail.com
Perin
Alessandra
A
Manzione
Luigi
L
Gebbia
Vittorio
V
Mattioli
Rodolfo
R
Speranza
Giovanni Battista
GB
Latini
Luciano
L
Iop
Aldo
A
Bertetto
Oscar
O
Ferraù
Francesco
F
Pugliese
Palma
P
Tralongo
Paolo
P
Zaniboni
Alberto
A
Di Costanzo
Francesco
F
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000523:psychology*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life
D000970:Antineoplastic Agents; D006454:Hemoglobins