Response to Anemia Treatment Differs in Lymphoma, Multiple Myeloma

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Anemia is fairly common in patients with blood cancers.
Anemia is fairly common in patients with blood cancers.

Patients with lymphoma who suffer from moderate to severe anemia may have better outcomes after 3 months receiving the same supportive treatment as patients with multiple myeloma (MM), and only increases in hemoglobin levels were significantly associated with improvements in fatigue and health-related quality of life (HRQoL), a study published in Supportive Care in Cancer has shown.

Anemia is a common comorbidity that occurs in approximately 70% of patients with blood cancers and has a negative impact on HRQoL. The purpose of this study was to analyze the impact and effectiveness of supportive therapies in anemia based on patient-reported outcomes.

For this prospective, observational study, researchers assessed the outcomes of 250 patients with lymphoma or MM. Patient perception of fatigue was assessed at baseline using the PERFORM questionnaire, the Functional Assessment of Cancer Therapy-Fatigue subscale, the linear analogue self-assessment, and visual analogue scale (VAS), and was assessed again at 3 months.

At baseline, 59.2% of patients with lymphoma and 56% of patients with MM received treatment for anemia, which consisted primarily of erythropoiesis-stimulating agents (ESAs). After 3 months, patients with lymphoma experienced a significant increase in hemoglobin levels from 10.0±1.2 to 11.5±1.8, and patients with MM had an increase from 9.9±0.9 to 10.9±1.5 g/dL (P <.001).

Approximately 87% and 85% of patients with lymphoma and MM, respectively, presented with fatigue at baseline with VAS scores of 60 and 40, respectively. At 3 months, fatigue scores improved in both groups for the PERFORM questionnaire (35.2±15.2 to 32.0±14.6; P =.048). The other scales did not have statistically significant changes.

The only common independent factor significantly associated with improvements in fatigue and HRQoL was an increase in hemoglobin levels. Administration of treatments with curative intent was also associated with HRQoL improvements.

Patients with lymphoma also saw improved fatigue outcomes as transferrin saturation levels decreased and albumin levels rose, suggesting the factors that modulate fatigue in MM and lymphoma may be different.

The authors concluded that, “an individualized therapeutic approach according to the specific disease seems desirable.”


Gason P, Arranz R, Bargay J, Ramos F. Fatigue- and health-related quality-of-life in anemic patients with lymphoma or multiple myeloma [published online November 7, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3948-5

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