title: A European patient record study on diagnosis and treatment of chemotherapy-induced anaemia.
abstract: OBJECTIVE
  Patients with cancer frequently experience chemotherapy-induced anaemia (CIA) and iron deficiency. Erythropoiesis-stimulating agents (ESAs), iron supplementation and blood transfusions are available therapies. This study evaluated routine practice in CIA management.
  
  
  METHODS
  Medical oncologists and/or haematologists from nine European countries (n=375) were surveyed on their last five cancer patients treated for CIA (n=1,730). Information was collected on tests performed at diagnosis of anaemia, levels of haemoglobin (Hb), serum ferritin and transferrin saturation (TSAT), as well as applied anaemia therapies.
  
  
  RESULTS
  Diagnostic tests and therapies for CIA varied across Europe. Anaemia and iron status were mainly assessed by Hb (94%) and ferritin (48%) measurements. TSAT was only tested in 14%. At anaemia diagnosis, 74% of patients had Hb ≤ 10 g/dL, including 15% with severe anaemia (Hb <8 g/dL). Low-iron levels (ferritin ≤ 100 ng/mL) were detected in 42% of evaluated patients. ESA was used in 63%of patients, blood transfusions in 52 % and iron supplementation in 31% (74% oral, 26% intravenous iron). Only 30% of ESA-treated patients received a combination of ESA and iron supplementation. Blood transfusions formed part of a regular anaemia treatment regimen in 76% of transfused patients. Management practices were similar in 2009 and 2011.
  
  
  CONCLUSIONS
  Management of anaemia and iron status in patients treated for CIA varies substantially across Europe. Iron status is only assessed in half of the patients. In contrast to clinical evidence, iron treatment is under utilised and mainly based on oral iron supplementation. Implementation of guidelines needs to be increased to minimize the use of blood transfusions.
authors.forename: Heinz
authors.initials: H
authors.lastname: Ludwig
authors.forename: M
authors.initials: M
authors.lastname: Aapro
authors.forename: C
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: J
authors.initials: J
authors.lastname: Glaspy
authors.forename: M
authors.initials: M
authors.lastname: Hedenus
authors.forename: T J
authors.initials: TJ
authors.lastname: Littlewood
authors.forename: A
authors.initials: A
authors.lastname: Österborg
authors.forename: B
authors.initials: B
authors.lastname: Rzychon
authors.forename: D
authors.initials: D
authors.lastname: Mitchell
authors.forename: Y
authors.initials: Y
authors.lastname: Beguin
mesh_terms: D000740:Anemia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D060828:Induction Chemotherapy; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D006454:Hemoglobins; D005293:Ferritins; D007501:Iron