• J R Skillings, I Rogers-Melamed, J M Nabholtz, C Sawka, F Gwadry-Sridhar, J P Moquin, M Rubinger, P Ganguly, M Burnell, C Shustik, D Dryer, M McLaughlin, and D White.
• Nova Scotia Cancer Centre, Halifax.
• Cancer Prev Control. 1999 Jun 1; 3 (3): 207-12.

ObjectiveThe objective of this chart review was to determine the frequency of transfusion and prevalence of anemia (hemoglobin result < 100 g/L) in patients receiving chemotherapy.DesignThis study was a retrospective review of medical charts.SettingPatients receiving chemotherapy were included from 12 tertiary care comprehensive cancer centres across Canada.Main Outcome MeasureThe primary study outcome measure was red blood cell transfusion rate, controlling for patient variables.ResultsThe 616 patients included had started chemotherapy in January-June 1992. For each subject, data collection finished 4 weeks after the end of the first regimen or after a maximum follow-up period of 26 weeks. Seventy-two patients (12%; 95% confidence interval 9.5% to 14.5%) were transfused for anemia (reasons other than blood loss), and 28% (95% confidence interval 24.5% to 31.5%) of the subjects were anemic during treatment. The univariate analyses of transfusion for anemia yielded significant associations with prognostic factors. In the multivariate analyses, platinum (odds ratio [OR] = 6.69) and anthracycline (OR = 3.56) chemotherapy, baseline hemoglobin (OR = 0.96) and disease stage (OR = 1.72) were statistically significant contributors.ConclusionIn this patient cohort, red blood cell transfusion was infrequent (12%). However, patient groups at high risk of transfusion could be identified, with platinum-based chemotherapy being the most significant contributing factor. The information obtained from this multicentre study may prove helpful in developing supportive care guidelines for the management of chemotherapy-related anemia requiring transfusion.

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