Analysis of the influence of various factors on anemia in patients with lymphoid malignancies

Anemia is a frequent complication of lymphoid neoplasms as a result of the disease and myelotoxic chemotherapy, and has a significant impact on treatment outcome, survival and quality of life. The aim of this study was to investigate clinical characteristics of anemia in lymphoid malignancies and to assess the need of anemia treatment in the context of modern therapeutic possibilities. Fifty-five patients (32 female and 23 male) with non-Hodgkin's lymphoma (NHL, n = 30), chronic lymphocytic leukemia (CLL, n = 8) and multiple myeloma (MM, n = 17) were included in the study. The influence of age, sex, type of malignancy and chemotherapy on the prevalence, severity and type of anemia before and after chemotherapy was analyzed. The prevalence of anemia was 51.02% before (A1) and 55.31% after (A2) chemotherapy. Women had a higher prevalence of anemia than men (63% vs. 43%), but the severity was higher in men at the beginning (103 vs. 99 g/L Hb) and at the end of treatment (101 vs. 89 g/L Hb). The highest prevalence of anemia was found in MM (69%), followed by NHL (44.4%) and CLL (40%) before chemotherapy, and in MM (68.7%), CLL (42.9%) and NHL (20.8%) after chemotherapy. The prevailing anemia was anemia of chronic disease (53.8%), followed by anemia due to multiple causes (anemia of chronic disease + iron deficiency anemia or anemia of chronic disease + hemolytic anemia; 30.7%), anemia due to iron deficiency (11.5%) and hemolytic anemia (7.6%). The prevalence of anemia as a consequence of the disease is high in lymphoproliferative disease, but there was no significant rise under chemotherapy, even showing a decline in NHL patients (44% vs. 21%), however, the severity of anemia increased. Since stage 1 anemia according to the WHO prevailed, only a small number of patients required transfusion therapy. About 27% of all patients had hemoglobin values <100 g/L during chemotherapy and could be candidates for erythropoiesis-stimulating agent treatment.