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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Retrospective studies of the relationship between perioperative blood transfusion and cancer recurrence are reviewed. Control for variables related to blood transfusion and potentially affecting disease recurrence--anemia, blood loss, duration of surgery, magnitude of the procedure, and stage of disease--was notably absent from the majority of studies. None of the negative studies had sufficient number of both transfused and untransfused patients to answer the question with statistical validity. No consensus emerged regarding the significance of blood transfusion for the cancer patient and no recommendations concerning the use of blood in patients with malignancies are justified on the basis of these studies.
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PMID:Does blood transfusion predispose to cancer recurrence? 265 May 28

A 65-year-old man underwent left-upper lobectomy for large cell carcinoma of the lung on November 8, 1984 (pT1N0M0: Stage I a). He was treated with MMC, Futraful, CDDP and CPM as adjuvant chemotherapy. In April 1985, he was re-admitted to our hospital because of progressive dyspnea. He was diagnosed as having drug-induced interstitial pneumonia, and so steroid therapy was started. In July 1985, he suffered from anemia, thrombocytopenia, proteinuria and azotemia progressively, and died due to pulmonary hemorrhage and edema. At necropsy, no cancer recurrence was found. It thus seemed that the cause of death was microangiopathic hemolytic anemia and renal failure induced by anti-neoplastic agents.
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PMID:[Microangiopathic hemolytic anemia (MAHA) and renal failure induced by anti-neoplastic agents--a case report]. 303 22

Retrospective studies of the relationship between perioperative blood transfusion and colorectal cancer recurrence are reviewed. Perioperative blood transfusion was associated with preoperative anemia, operations for rectal carcinoma, presence of tumor in the right colon, prolonged procedures, and copious blood loss. Control for variables related to blood transfusion and potentially affecting disease recurrence--blood loss, duration of surgery, and magnitude of the procedure--was notably absent from the majority of studies. None of the negative studies had sufficient numbers of both transfused and untransfused patients to reject the hypothesis that blood transfusion is associated with cancer recurrence with statistical validity. No concensus emerged regarding the significance of blood transfusion for the patient with colorectal cancer, and no recommendations concerning the use of blood are justified on the basis of these studies.
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PMID:Perioperative blood transfusion and colorectal cancer recurrence: a review. 305 36

The definitive study of the relationship between blood transfusion and cancer recurrence has not been published. The existing studies fail to adequately control for anemia, duration of surgery, magnitude of the procedure, blood loss, and stage of disease, variables that are related to the administration of blood and are also associated with cancer recurrence. None of the negative studies has the number of patients necessary to achieve statistical validity. Experimental studies indicate that tumor growth may be inhibited or promoted by allogeneic blood transfusion depending on the route and timing of the transfusion relative to tumor inoculation, the route of tumor inoculation and the specific tumor used, and the strain and species of the animal and blood donor. The available evidence suggesting a relationship between blood transfusion and cancer recurrence does not support any changes in the use of blood for patients with malignancies.
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PMID:Blood transfusion and tumor growth. 305 92

Anemia is common in cancer patients. The pathophysiology is multifactorial, however the most common cause is the anemia of chronic diseases (ACD). In 20-50% of cancer patients, anemia restricts physical activity and quality of life and requires transfusion support. The percentage of patients necessitating transfusion dramatically increases when patients require surgery. The traditional belief that blood transfusion is an effective and safe therapy has been challenged by a heightened awareness of the infectious and immunologic risks associated with allogeneic blood administration. In cancer patients transfusion-induced immunomodulation may have the potential to significantly increase postoperative infections and cancer recurrence so that it seems reasonable to minimize allogeneic blood exposure. Several strategies have been adopted to reduce allogeneic transfusion in surgical patients, however to properly select the appropriate blood conservation strategies the blood transfusion requirements for each patient should be defined. Allogeneic blood transfusion in surgery can be reduced by the introduction of autologous blood (AB) programmes and by the use of rHuEPO, alone or in association with AB techniques. AB donation is currently a standard of care for elective surgical patients but its efficacy is limited by anemia that prevents the donation of the optimal number of AB units. rHuEPO has been shown to significantly increase the volume of AB that anemic patients can predeposit or, used perisurgically, to expand the circulating RBCs mass before surgery. Moreover clinical trials employed rHuEPO in anemic cancer patients with various solid tumors both on and off chemotherapy reporting a significantly increase in Hct in more than 50% of the treated patients. Recently different studies have shown the efficacy of rHuEPO in increasing the volume of AB also in patients with ACD and cancer, thus proving to be a useful addition to existing strategies of blood conservation to minimize exposure to allogeneic blood in surgical cancer patients.
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PMID:[Blood transfusion in oncologic surgery: the role of recombinant human erythropoietin (rHuEPO)]. 1008 89

TS-1, a novel oral formation of 5-fluorouracil, consists of 1 M tegafur (5-FU), 0.4 M CDHP and 1 M Oxo. The response rate in the late phase II study was reported as 49% in the patients with advanced gastric cancer. We report two patients with metastases from gastric cancer who markedly responded to TS-1. CASE 1: A 74-year-old man who suffered abdominal tumor was admitted to our hospital. Computed tomography (CT) showed advanced gastric cancer with huge liver metastases and extensive lymph node metastases. After 120 mg of TS-1 was orally administered for 12 weeks, CT showed a 77% reduction in the liver metastases. No serious adverse reactions were observed. CASE 2: A 66-year-old man had undergone a curative distal gastrectomy with D2 lymphadenectomy. One year later, CT showed enlargement of paraaortic lymph nodes due to cancer recurrence. There were no metastatic lesions in the other organs. After 100 mg of TS-1 was orally administered for 4 weeks, CT revealed that almost complete reduction of the metastatic nodes was obtained. Adverse reactions at grade 2 for leucopenia and anemia were observed. In conclusion, TS-1 was effective and well tolerable for patients with advanced gastric cancer.
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PMID:[Two cases of advanced gastric cancer responding to TS-1: a novel oral formation of 5-fluorouracil]. 1096 3

Preoperative, operative, and postoperative factors may all contribute to high rates of anemia in patients undergoing surgery for cancer. Allogeneic blood transfusion is associated with both infectious risks and noninfectious risks such as human errors, hemolytic reactions, transfusion-related acute lung injury, transfusion-associated graft-versus-host disease, and transfusion-related immune modulation. Blood transfusion may also be associated with increased risk of cancer recurrence. Blood-conservation measures such as preoperative autologous donation, acute normovolemic hemodilution, perioperative blood salvage, recombinant human erythropoietin (epoetin alfa), electrosurgical dissection, and minimally invasive surgical procedures may reduce the need for allogeneic blood transfusion in elective surgery. This review summarizes published evidence of the consequences of anemia and blood transfusion, the effects of blood storage, the infectious and noninfectious risks of blood transfusion, and the role of blood-conservation strategies for cancer patients who undergo surgery. The optimal blood-management strategy remains to be defined by additional clinical studies. Until that evidence becomes available, the clinical utility of blood conservation should be assessed for each patient individually as a component of preoperative planning in surgical oncology.
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PMID:Anemia and transfusions in patients undergoing surgery for cancer. 1794 90

Fluid resuscitation is intended to eliminate microcirculatory disorders and restore adequate tissue oxygenation. The safety limits for a restrictive transfusion policy are given by patients' individual tolerance of acute normovolemic anemia. Artificial oxygen carriers based on perfluorocarbon or hemoglobin are attractive alternatives to allogenic red blood cells. There are many risks involved in allogenic blood transfusions and they include transmission of infections, delayed postoperative wound healing, transfusion reactions, immunomodulation and cancer recurrence. Regardless of whether artificial oxygen carriers are available for routine clinical use, further studies are needed in order to show the safety and efficacy of these substances for clinical practice.
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PMID:Artificial oxygen carriers as a possible alternative to red cells in clinical practice. 1959 85

Worldwide, colorectal cancer (CRC) is one of the most common forms of malignancy and is increasing in incidence in many regions. At diagnosis, approximately 40% of patients with CRC are anemic, a figure that increases over the course of a patient's treatment due to many factors, including ongoing hemorrhage. Preoperative anemia is therefore associated with increased allogenic red blood cell transfusion (ARBT) rates. In the context of CRC, perioperative ARBT has been linked with adverse postoperative outcomes, including higher morbidity, mortality and cancer recurrence rates. Therefore, strategies to potentially reduce the need for ARBT have been the focus of several recent studies. We critically evaluate a recent paper that explores intravenous iron III sucrose as a treatment option for the management of postoperative anemia in CRC patients. This study is a retrospective, observational case-controlled study that was designed to evaluate whether the use of postoperative intravenous iron reduces the incidence of ARBT following CRC resection.
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PMID:Is there a role for intravenous iron therapy in patients undergoing colorectal cancer resection? 2255 96

Anemia, usually due to iron deficiency, is highly prevalent among patients with colorectal cancer. Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization. Preoperative anemia predicts for decreased survival. Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes, increased post-operative nosocomial infections, longer hospital stays, increased rates of cancer recurrence and perioperative venous thromboembolism. Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management, minimizes or eliminates allogeneic blood transfusion. This includes restrictive transfusion policy, thromboprophylaxis and anemia management to improve outcomes. Normalization of preoperative hemoglobin levels is a World Health Organization recommendation. Iron repletion should be routinely ordered when indicated. Oral iron is poorly tolerated with low adherence based on published evidence. Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions. Serious adverse events with intravenous iron are extremely rare. Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care. Erythropoiesis stimulating agents may improve response rates. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.
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PMID:Perioperative anemia management in colorectal cancer patients: a pragmatic approach. 2458 73


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