Analysis Of The Factors Influencing Effect Of RhEPO On Anemic Patients With Tumor

Objective:To observe the therapeutic effect of Recombinant Human Erythropoietin(rhEPO) on chemotherapy of anemic patients with solid tumor, and to analyze the correlation between therapeutic effect of Recombinant Human Erythropoietin and patients clinical characteristics,chemotherapy regiments and nutritional status, and to detect the influencing factors of the therapeutic effect of Recombinant Human Erythropoietin.Methods:The study collected clinical data of chemotherapy of anemic patients with solid tumor in Liaoning Cancer Hospital and Institute from August 2013 to October 2014, Patients were selected if HGB<10g/dL after chemotherapy, and excluded the patients of Head and Neck Cancers and early breast cancers, if the anemia caused by deficiency of iron, folic acid, VitB12 were excluded. If the patients had a blood transfusion, bone marrow invasion or macrocytic anemia were also excluded. A total of 109 cases, including 53 cases of breast cancer,53 cases of lung cancer,5 cases of gastric cancer,1 cases ovarian cancer,5 cases of colorectal cancer,1 case with esophageal carcinoma,4 cases of other carcinoma.Then we analyzed the correlation between therapeutic effect of Recombinant Human Erythropoietin and patients clinical characteristics and the factors influencing the effect of Recombinant Human Erythropoietin on chemotherapy of anemic patients with solid tumor.1.The data included age, gender, TNM stage, bone metastasis, infection, whether contained platinum in chemotherapy, nutritional status including BMI and serum total cholesterol(TC), triglycerides(TG), high-density lipoprotein(HDL) and low density lipoprotein(LDL). And Serum iron (SI)、serum ferritin(SF、total iron binding capacity (TIBC)、reticulocyte (Ret)、folic acid (FA)、VitB12 were collected.2.The statistics analysis were performed using SPSS17.0.χ2 test and Fisher exact test were used to analyze the associations between patients clinical characteristics, chemotherapy regiments, nutritional status and therapeutic effect of Recombinant Human Erythropoietin. Binary logistic regression analysis was used to analyze the related factors with therapeutic effect of Recombinant Human Erythropoietin. It is considered significantly different if P<0.05 with a two-side.Results:1、General data analysis:109 patients were eligible for the study, of which 42 patients(39%) were male and 67 patients(61%) were female. The mean age was 59years. Among them,57(52%) patients were younger than 60 years,52(48%) patients were aged 60 years and older. In the stage I-II group, patients were 17 (16%) stage III-IV patients were 92 (84%), and 32 (29%) patients were with bone metastasis, 77 (71%) patients were without. The patients who accepted the chemotherapy of containing platinum was 67 (61%), the other was 42(39%). The patients who accepted centrum or pelvis radiotherapy was 5(5%), and the other place was 25 (23%), patients who had not radiotherapy was 79 (72%). During the treatment period, the patients who were infected proved by microbiological examination, hemogram or symptoms were 15 (14%), and without infection was 94 (86%). In the nutritional status, patients in the group of BMI＜25kg/m2 was 79 (72%), BMI≥25 kg/m2 group contained 30 (28%) High LDL level and normal LDL level contained 70 (64%) and 39 (36%) patients respectively; Low HDL level and normal HDL level contained 23 (21%) and 86 (79%) patients respectively; High TC level and normal TC level contained 16 (15%) and 93 (85%) patients respectively; High TG level and normal TG level contained 39 (36%) and 70 (64%) patients respectively.2、After Recombinant Human Erythropoietin therapy, about 49% patients had the effective outcome.3、Through the single factor analysis the result showed that these factors such as age(<60 or≥60), TNM stage(Ⅰ-Ⅱ or Ⅲ-Ⅳ), bone metastasizing status, Platinum containing chemotherapy and infection had influence on the effect of Recombinant Human Erythropoietin (P<0.05). But gender, radiotherapy and nutritional status did not(P>0.05).4、The results through the binary logistics regression model analysis showed that the independent forecast factors for poor therapeutic effect of Recombinant Human Erythropoietin are patients aged 60 years and older[P=0.016, OR=3.308,95%CI (1.254-8.725)], bone metastasis[P=0.046, OR=2.867,95%CI (1.018-8.027)], chemotherapy of containing platinum[P=0.029, OR=2.706,95%CI(1.106-6.621)] and infection [P=0.008, OR=8.198,95%CI(1.745-38.510)]. TNM stage is not independent forecast factor.Conclusion:1、The Recombinant Human Erythropoietin treated chemotherapy of anemic patients with solid tumor was effective.2、Age, Bone metastasis, Platinum containing was associated with curative effect of Recombinant Human Erythropoietin in treating tumor associated anemia, they are the independent risk factors for poor curative effect.3、Infection was associated with curative effect of Recombinant Human Erythropoietin in treating anemia tumor-patients with chemotherapy, it is also the independent risk factor for poor curative effect, and the relationship was highly. Therefore, we suggest the patients who accompanied with infection should be combined anemia therapy and anti-infection therapy actively.