Association of Anaemia with Metastasis in Non Haematological Malignancies: A Cross-sectional Study

Abstract

Introduction: Anaemia and cancer are two non communicable diseases with high global prevalence. The presence of anaemia in cancer patients is common, and its aetiology is multifactorial. Aim: To analyse the clinical profile, type and severity of anaemia in non haematological malignancies and to determine how the presence of metastasis affects it. Materials and Methods: A cross-sectional study was conducted in the Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, between January 2022 and December 2023. Out of 1,294 patients diagnosed with malignancy, 190 subjects were analysed. The study included patients over 18 years of age diagnosed with non haematological malignancies who had anaemia according to the World Health Organisation (WHO) definition {females with Haemoglobin (Hb) <12 g/dL; males with Hb <13 g/dL}. The subjects were divided into two groups: patients with and without metastatic disease. All patients underwent complete haemogram, iron studies, serum vitamin B12 levels and serum folate levels. Anaemia was classified into types: normocytic anaemia, microcytic anaemia and macrocytic anaemia. The student’s t-test, Chi-square test and Fisher’s exact test were used to analyse and interpret the collected data. Results: Of the 190 selected subjects, 80 (42.1%) (group A) had metastatic disease, while 110 (57.9%) (group B) had no evidence of metastasis. The mean±Standard Deviation (SD) age of patients in group A was 55.43±11.12 years and in group B was 54.38±9.8 years. There were 90 males and 100 females in the study. The most common cause of anaemia was found to be chemotherapy-induced anaemia. The most common type of anaemia among all study subjects was normocytic anaemia (52.1%). The prevalence of severe anaemia was significantly higher in patients with metastatic cancers compared to those without metastatic cancers (p-value=0.0003). Conclusion: Chemotherapy-induced and normocytic anaemia were the most common types of anaemia in non haematological malignancies. Severe anaemia was more prevalent in patients with metastatic cancers. Anaemia in cancer patients should be monitored and managed optimally to improve outcomes.

Keywords

• breast neoplasms
• carcinoma
• head and neck neoplasms
• neoplasm metastasis