title: Management of anemia and iron deficiency in a cancer center in France.
abstract: OBJECTIVE
  Anemia affects most patients treated for cancer by chemotherapy. It is a known major contributor to fatigue and loss of quality of life and is likely to have a negative effect on prognosis and mortality from cancer. The main purpose of this study was to characterize the management of anemia and iron deficiency in a French oncology day-care center.
  
  
  METHODS
  A retrospective study was conducted between May and November 2012 in the oncology day unit of the Jean Godinot Cancer Center (France). The 133 patients included were all over the age of 18 and being treated by chemotherapy and had mild, moderate, or severe anemia.
  
  
  RESULTS
  Over half (58%) the patients were shown to be receiving no specific treatment for anemia. Iron balance was assessed in 71 patients and iron deficiency diagnosed in 37. Stepwise logistic regression showed that patients with severe to moderate anemia were nearly four times more likely to have an iron balance assessment than those with mild anemia (OR, 3.78; 95% CI, 1.84-7.76; P = 0.0003). Classical logistic regression shows that older patients (≥70) are three times less likely to have an iron balance assessment than patients <70 years (OR, 0.32; 95% CI, 0.12-0.86; P = 0.06).
  
  
  CONCLUSIONS
  An ideal medical setting for the management of anemia and iron deficiency, and the associated quality-of-life concerns, has yet to be defined for patients with cancer. Screening and treatment of mild to moderate anemia are inadequate, despite the advent of erythropoiesis-stimulating agents. Large scale, multicenter studies are required to define a clear medical framework for the management of anemia and iron deficiency.
authors.affiliation: Jean Godinot Unicancer Institute, 1 avenue du général Köenig, CS80014, 51726, Reims, France. florencelt@hotmail.fr.
authors.forename: Florence
authors.initials: F
authors.lastname: Laï-Tiong
authors.affiliation: Jean Godinot Unicancer Institute, 1 avenue du général Köenig, CS80014, 51726, Reims, France.
authors.forename: Cloé
authors.initials: C
authors.lastname: Brami
authors.affiliation: Jean Godinot Unicancer Institute, 1 avenue du général Köenig, CS80014, 51726, Reims, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dubroeucq
authors.affiliation: European Georges Pompidou Hospital, Paris, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Scotté
authors.affiliation: Jean Godinot Unicancer Institute, 1 avenue du général Köenig, CS80014, 51726, Reims, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Curé
authors.affiliation: Jean Godinot Unicancer Institute, 1 avenue du général Köenig, CS80014, 51726, Reims, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jovenin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000628:therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D019468:Disease Management; D005260:Female; D005602:France; D006801:Humans; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D011788:Quality of Life; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: Anemia; Cancer-induced anemia; Chemotherapy-induced anemia; Intravenous iron; Iron deficiency