Data Show Transfusion Patterns In Chemotherapy-Induced Anemia Patients
Analyses reported a significantly lower proportion of patients receiving transfusions when erythropoiesis-stimulating agents (ESAs) treatment was initiated at hemoglobin (Hb) levels between 10 to 11 grams per deciliter (g/dL) of blood compared with patients having Hb levels less than 10 g/dL prior to ESA treatment. In addition, wide variability in hemoglobin levels prior to transfusion was reported.
These analyses were conducted using data from the ongoing prospective, observational Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies (DOSE) Registry, sponsored by Centocor Ortho Biotech Services, L.L.C.
"Observational data reflect real-world clinical practice and therefore these findings are important in helping to understand transfusion patterns," said Kay Larholt, Sc.D., Vice President, Biometrics at Abt Associates, a biopharmaceutical research and consulting firm, and lead author of both analyses presented today. "The analyses indicate that the presence of a lower hemoglobin when ESA therapy was initiated was associated with a higher need for transfusion, and suggest initiation at a hemoglobin between 10 to 11 g/dL may reduce the need for transfusion."
Methodology and Results
For both analyses, real-world data on ESA-treated patients in 48 U.S. oncology clinics were analyzed from the DOSE Registry. Data were collected from participating hospital- and community-based outpatient practices between December 2003 and July 2007.
In the first analysis of 969 patients, transfusion data were analyzed from adult chemotherapy-treated oncology patients that received at least two ESA doses. Results of the analysis were as follows:
-- A significantly greater proportion of chemotherapy-treated patients received transfusions when ESA treatment was initiated at Hb levels below 10 g/dL compared with patients having Hb levels of 10 to 11 g/dL prior to ESA administration: 31% vs. 14%, respectively, p<0.0001.
-- Greater blood utilization was observed in those initiated on ESA therapy at Hb levels less than 10 g/dL compared with Hb levels of 10 to 11 g/dL: 0.89 vs. 0.44 Units/study patient, respectively, p<0.0001.
In a second analysis of 314 patients who received transfusion, Hb values within three days before transfusion were assessed and summarized. The observed Hb levels prior to transfusion ranged from 5.4 to 11 g/dL, including 64 percent of transfusions in patients with Hb levels greater than or equal to 8 g/dL. Nineteen percent of transfusions occurred at Hb levels greater than or equal to 9 g/dL and four percent occurred at Hb > 10 g/dL.