Advanced prostate Ca patients with worsening anemia may face poorer outcomes

Shortened survival and earlier relapse have been reported in men with advanced prostate cancer whose hemoglobin levels decline during the first 3 months of hormone therapy, according to a study published in Cancer (2006; 107:489-96).

Researchers studied the multivariate associations between a 3-month change in hemoglobin levels after the start of androgen-deprivation therapy in 817 advanced prostate cancer patients. A linear regression model was used to evaluate baseline characteristics.

Median pretreatment hemoglobin was 13.7 g/dL before treatment and 12/8 g/dL after treatment. Overall, the mean change in hemoglobin between the baseline measurement and the 3-month follow-up was a decrease of .54 g/dL. Patients with a drop in hemoglobin of 1.6 g/dL or more during that period had a 31% higher risk of death than did those whose hemoglobin increased by more than .3 g/dL.

“These results suggest that by monitoring anemia during the first 3 months of treatment, we can provide men with a better idea of how well they will fare,” said principal investigator Tomasz Beer, MD, of the Oregon Health & Science University Cancer Institute in Portland.

Race alone was not a strong predictor of survival or disease progression, according to the authors. However, they found that men with the same hemoglobin levels before treatment experienced significantly different overall and progression-free survival, depending on whether they were African-American or Caucasian. Investigators also found that anemic African-Americans fared worse than anemic Caucasians.