[The occurrence of anemia in small cell lung cancer patients during first-line chemotherapy]

Both the character of disease and its aggressive treatment--including cisplatin-based chemotherapy--reflected to fact that anemia is a frequent problem in SCLC patients. Moreover, the potential prognostic role of anemia is considered in this group of patients. The aim of the study was to analyze occurrence of anemia in SCLS patients subjected to first line chemotherapy with the special attention paid to its potential prognostic role.

The retrospective analysis included 49 SCLS patients (including 22 and 27 LD and ED ones, respectively) treated in 2001-2004 at the Internal Disease Clinic in 4th Military Academic Hospital in Wrocław Primary chemotherapy (cisplatin + etoposide) was performed in ED cases, whereas sequence treatment: chemotherapy (cisplatin + etoposide) with subsequent radiotherapy (including the elective irradiation of the central nervous system) was implemented in LD patients. Therapeutic results were evaluated in terms of response to treatment graded in accordance with RECIST criteria, time to progression (TTP) and overall survival (OS). Pretreatment anemia was identified based on the WHO criteria. Moreover, the maximal severity of anemia during the chemotherapy and the frequency of erythrocyte mass transfusions were taken into account.

Pretreatment anemia (defined in accordance to WHO) was noted in 3/49 patients only. During the chemotherapy, however, it was noted in 21/49 cases (WHO grade I and II). The transfusion of erythrocyte mass was necessary in 9 patients, whereas the preparations of recombined erythropoietin were given in 3 cases. No prognostic role of anemia was proved in the group studied. The significant association, however, was noted between pretreatment anemia and PS according to WHO (p < 0.001).

Anemia is a frequent problem during SCLC treatment and requires special therapy in most cases. The prognostic significance of anemia, however, is not fully understood, either in radical or in palliative treatment of SCLC patients. Our study revealed the lack of an association between anemia in prognosis.