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Annals of Oncology Advance Access published online on October 26, 2005
Annals of Oncology, doi:10.1093/annonc/mdj038
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© 2005 European Society for Medical Oncology
Received June 8, 2005
Revised August 8, 2005
Accepted September 5, 2005

original article

Correlation between anemia and functional/cognitive capacity in elderly lung cancer patients treated with chemotherapy

A. Mancuso 1, M. Migliorino 1, S. De Santis 1, A. Saponiero 1, and F. De Marinis 2*

1 5th Pneumo-Oncology Unit, Department of Lung Diseases, S. Camillo-Forlanini Hospital, Rome, Italy
2 5th Pneumo-Oncology Unit, Department of Lung Diseases, S. Camillo-Forlanini Hospital, Rome, Italy; FoRO (Fondazione per la Ricerca Oncologica), Rome, Italy

* To whom correspondence should be addressed.
F. De Marinis, E-mail: f.demarinis{at}oncpneumo.it


  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).

Patients and 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.

Keywords: anemia; chemotherapy; elderly; geriatric assessment.
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