Cargando…
Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries
Cancer-associated anemia (CAA) remains a major unmet need that compromises overall survival (OS) and quality of life (QoL). Currently, available guidelines do not take into consideration the unique challenges in low- and middle-income countries (LMIC). Our CAA patients have to battle preexisting imp...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2023
|
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635760/ https://www.ncbi.nlm.nih.gov/pubmed/37969669 http://dx.doi.org/10.1055/s-0043-1771445 |
_version_ | 1785146357768519680 |
---|---|
author | Parikh, Purvish Mahendra Aggarwal, Shyam Biswas, Ghanashyam Gulia, Seema Agarwala, Vivek Basade, Maheboob Mohapatra, P.N. Vamshi, Krishna Muddu Warrier, Arun Prasad, Krishna Roy, Partha Chandrakant, M.V. Malhotra, Hemant Hingmire, Sachin Paul, Davinder Maniar, Vashista Gupta, Alok Panda, Soumya S. Samar, Aseem Rohatgi, Nitesh Dattatreya, Satya Krishnamurthy, Manjunath Thirumalairaj, Raja |
author_facet | Parikh, Purvish Mahendra Aggarwal, Shyam Biswas, Ghanashyam Gulia, Seema Agarwala, Vivek Basade, Maheboob Mohapatra, P.N. Vamshi, Krishna Muddu Warrier, Arun Prasad, Krishna Roy, Partha Chandrakant, M.V. Malhotra, Hemant Hingmire, Sachin Paul, Davinder Maniar, Vashista Gupta, Alok Panda, Soumya S. Samar, Aseem Rohatgi, Nitesh Dattatreya, Satya Krishnamurthy, Manjunath Thirumalairaj, Raja |
author_sort | Parikh, Purvish Mahendra |
collection | PubMed |
description | Cancer-associated anemia (CAA) remains a major unmet need that compromises overall survival (OS) and quality of life (QoL). Currently, available guidelines do not take into consideration the unique challenges in low- and middle-income countries (LMIC). Our CAA patients have to battle preexisting impaired nutritional status, depleted body iron stores, financial limitations, and difficulty in having easily accessible affordable healthcare. Hence, we fulfilled the need of guidelines for LMIC. A group of subject experts were put together, given background literature, met in a face-to-face discussion, voted using Delphi process, and finally agreed on the contents of this guideline document. As many as 50% of cancer patients will have significant anemia (hemoglobin < 10 g/dL) at initial diagnosis. It is most commonly seen with gastrointestinal malignancies, head and neck cancers, and acute leukemias. The hemoglobin falls further after initiation of cancer directed therapy, due to chemotherapy itself or heightened nutritional deficiency. Its evaluation should include tests for complete blood count, red blood cell morphology, reticulocyte count, Coombs test, and levels of vitamin B12 and folic acid. Iron status should be monitored using test to measure serum iron, total iron binding capacity, transferring saturation, and serum ferritin levels. A minimum of 50% of cancer patients with anemia require iron supplements. The preferred mode of therapy is with intravenous (IV) iron using ferric carboxymaltose (FCM). Most patients respond satisfactorily to single dose of 1000 mg. It is also safe and does not require use of a test dose. Significant anemia is found in at least half of all cancer patients in India, South Asian Association for Regional Cooperation region, and other LMIC countries. Its awareness among healthcare professionals will prevent it from remaining undiagnosed (in up to 70% of all cancer patients) and adversely affecting OS and QoL. The benefits of treating them with IV iron therapy are quick replenishment of iron stores, hemoglobin returning to normal, better QoL, and avoiding risk of infections/reactions with blood transfusions. Many publications have proven the value of single-dose FCM in such clinical situations. CAA has been proven to be an independent prognostic factor that adversely affects both QoL and OS in cancer patients. Use of FCM as single IV dose of 1000 mg is safe and effective in the majority of patients with CAA. |
format | Online Article Text |
id | pubmed-10635760 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106357602023-11-15 Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries Parikh, Purvish Mahendra Aggarwal, Shyam Biswas, Ghanashyam Gulia, Seema Agarwala, Vivek Basade, Maheboob Mohapatra, P.N. Vamshi, Krishna Muddu Warrier, Arun Prasad, Krishna Roy, Partha Chandrakant, M.V. Malhotra, Hemant Hingmire, Sachin Paul, Davinder Maniar, Vashista Gupta, Alok Panda, Soumya S. Samar, Aseem Rohatgi, Nitesh Dattatreya, Satya Krishnamurthy, Manjunath Thirumalairaj, Raja South Asian J Cancer Cancer-associated anemia (CAA) remains a major unmet need that compromises overall survival (OS) and quality of life (QoL). Currently, available guidelines do not take into consideration the unique challenges in low- and middle-income countries (LMIC). Our CAA patients have to battle preexisting impaired nutritional status, depleted body iron stores, financial limitations, and difficulty in having easily accessible affordable healthcare. Hence, we fulfilled the need of guidelines for LMIC. A group of subject experts were put together, given background literature, met in a face-to-face discussion, voted using Delphi process, and finally agreed on the contents of this guideline document. As many as 50% of cancer patients will have significant anemia (hemoglobin < 10 g/dL) at initial diagnosis. It is most commonly seen with gastrointestinal malignancies, head and neck cancers, and acute leukemias. The hemoglobin falls further after initiation of cancer directed therapy, due to chemotherapy itself or heightened nutritional deficiency. Its evaluation should include tests for complete blood count, red blood cell morphology, reticulocyte count, Coombs test, and levels of vitamin B12 and folic acid. Iron status should be monitored using test to measure serum iron, total iron binding capacity, transferring saturation, and serum ferritin levels. A minimum of 50% of cancer patients with anemia require iron supplements. The preferred mode of therapy is with intravenous (IV) iron using ferric carboxymaltose (FCM). Most patients respond satisfactorily to single dose of 1000 mg. It is also safe and does not require use of a test dose. Significant anemia is found in at least half of all cancer patients in India, South Asian Association for Regional Cooperation region, and other LMIC countries. Its awareness among healthcare professionals will prevent it from remaining undiagnosed (in up to 70% of all cancer patients) and adversely affecting OS and QoL. The benefits of treating them with IV iron therapy are quick replenishment of iron stores, hemoglobin returning to normal, better QoL, and avoiding risk of infections/reactions with blood transfusions. Many publications have proven the value of single-dose FCM in such clinical situations. CAA has been proven to be an independent prognostic factor that adversely affects both QoL and OS in cancer patients. Use of FCM as single IV dose of 1000 mg is safe and effective in the majority of patients with CAA. Thieme Medical and Scientific Publishers Pvt. Ltd. 2023-09-15 /pmc/articles/PMC10635760/ /pubmed/37969669 http://dx.doi.org/10.1055/s-0043-1771445 Text en MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Parikh, Purvish Mahendra Aggarwal, Shyam Biswas, Ghanashyam Gulia, Seema Agarwala, Vivek Basade, Maheboob Mohapatra, P.N. Vamshi, Krishna Muddu Warrier, Arun Prasad, Krishna Roy, Partha Chandrakant, M.V. Malhotra, Hemant Hingmire, Sachin Paul, Davinder Maniar, Vashista Gupta, Alok Panda, Soumya S. Samar, Aseem Rohatgi, Nitesh Dattatreya, Satya Krishnamurthy, Manjunath Thirumalairaj, Raja Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title | Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title_full | Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title_fullStr | Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title_full_unstemmed | Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title_short | Practical Clinical Consensus Guidelines for the Management of Cancer Associated Anemia in Low- and Middle-Income Countries |
title_sort | practical clinical consensus guidelines for the management of cancer associated anemia in low- and middle-income countries |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635760/ https://www.ncbi.nlm.nih.gov/pubmed/37969669 http://dx.doi.org/10.1055/s-0043-1771445 |
work_keys_str_mv | AT parikhpurvishmahendra practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT aggarwalshyam practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT biswasghanashyam practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT guliaseema practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT agarwalavivek practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT basademaheboob practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT mohapatrapn practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT vamshikrishnamuddu practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT warrierarun practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT prasadkrishna practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT roypartha practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT chandrakantmv practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT malhotrahemant practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT hingmiresachin practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT pauldavinder practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT maniarvashista practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT guptaalok practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT pandasoumyas practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT samaraseem practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT rohatginitesh practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT dattatreyasatya practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT krishnamurthymanjunath practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries AT thirumalairajraja practicalclinicalconsensusguidelinesforthemanagementofcancerassociatedanemiainlowandmiddleincomecountries |