The Japan Society of Clinical Oncology and The Japan Society of Transfusion Medicine and Cell Therapy jointly conducted a questionnaire-based survey on chemotherapy-induced anemia(CIA)in cancer patients between September and November 2010, the results of which are outlined here. For all the eight main cancer types in Japan that were analyzed(breast, lung, stomach, colorectal, liver, gynecologic, and urologic cancers and malignant lymphoma), blood transfusion was required in 1.6-24.0%(mean=7.5%)of patients who received chemotherapy, and 3.9-7.3 units(mean=5.9 units)red blood cells were transfused per patient. Approximately 146,000 units of red blood cells, accounting for 2.2%of the total annual supply of red blood cell products, was estimated to be transfused to cancer patients with CIA every year. In addition, approximately 172,000 cancer patients with CIA, accounting for 40% of patients receiving chemotherapy, were estimated to have hemoglobin(Hb)levels below 10 g/dL annually. In patients who received red blood cell transfusions, the average Hb level prior to chemotherapy was 9.5 g/dL and the average lowest Hb level after starting chemotherapy was 6.9 g/dL; these values were 11.6 g/dL and 10.4 g/dL, respectively, in patients who did not receive transfusion. Furthermore, for all cancer types, almost no red blood cell transfusions were performed in patients with an Hb level of 8.0 g/dL or higher, although many patients with an Hb level of 6.9 g/dL or lower also did not receive red blood cell transfusions. These results highlight the strict restriction of red blood cell transfusion to cancer patients with CIA. Therefore, the use of alternative therapies such as erythropoiesis-stimulating agents should be considered to improve the quality of life of cancer patients with CIA.
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