1Russian Research Institute of Hematology and Transfusiology, Russian Federal of Medical-biological Agency, Saint-Petersburg, 191024, 2nd Sovietskaya str., 16
2Children Hospital of St. Olga, Saint-Petersburg, 194156, str. Zemledelcheskaya, 2
Aims. To assess alteration of quality of life (QoL) in anemic patients with lymphoproliferative disorders (LPD) treated with Red blood cells transfusions (RBCsT) and Erythropoiesis-stimulating agents (ESA).
Patients and Methods. There were included 131 anemic patients with LPD (multiple myeloma, low-grade non-Hodgkin\'s lymphoma, chronic lymphocytic leukemia). Median age of patients was 67 years (range 24-85). All persons were divided into two groups: 1st group included patients (n=54) treated with RBCsT, 2nd (n=77) – treated with ESA. Posetive response for ESA considered as achievement of hemoglobine concentration 120 g/L or increase Hb ≥ 20 g/L. QoL was studied with Functional Assessment of Cancer Therapy Anemia subscale (FACT-An) and Fatigue subscale (FACT-F).
Results. In the 1st group of patients treated with RBCsT (in average 3.7±0.3 Units) concentration of Hb increased from 70.0±1.6 g/L to 93.1±1.2 g/L. Statistically significant improvement of their QoL was found in FACT-An subscale – from 41.1±2.0 (95% Cl=37.1-45.0) to 34.2±2.1 (95% Cl=30.0-38.3) points (p<0.001; n=54). Improvement of QoL was also found in FACT-F subscale – from 30.2±1.4 (95% Cl=27.8-32.9) to 23.2±1.5 (95% Cl=19.8-26.9) points (p<0.0001; n=54). In the 2nd group positive response for ESA-therapy was found in 52 (67.5%) out of 77 patients: 39 (50.6%) patients achieved the Hb concentration 120 g/L and 13 (16.9%) ones increased Hb more than 20 g/L. The patients with positive response increased the Hb concentration significantly from 88.4±1.4 g/L to 123.1±2.4 g/L (p<0.0001; n=52). We found out improvement of QoL in both subscale: in FACT-An – from 34.5±1.7 (95% Cl=31.1-37.9) to 30.1±1.6 (95% Cl=26.9-33.2) points (p<0.001; n=52) and in FACT-F – from 22.8±1.3 (95% Cl=20.3-25.4) to 19.7±1.2 (95% Cl=17.3-22.1) points (p=0.013; n=52).
Conclusions. Both RBCsT and ESA-therapy are able to increase Hb concentration considerably and improve QoL. However the RBCsT patients had more severe anemia and over a period of its correction the RBCsT patients’s planned level of Hb was less than ESA-patietnts’s one therefore their final QoL was less. So using the ESA-therapy can increase higher Hb concentration and improve QoL more than RBCsT. It’s indicating importance of ESA-therapy not as alternative RBCsT method of anemia’s correction but also as a way to prevent decreasing of the Hb induced by toxic effect of chemotherapy and as a method of anemia treatment with which a normal Hb level can be achieved.
lymphoproliferative disorders, erythropoiesis-stimulating agents, anemia, hemoglobin, red blood cell, red blood cell transfusions, hematologic, quality of life, subscale FACT-An, FACT-F
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