An epidemiological review of red cell transfusions in cancer chemotherapy

Cancer Prev Control. 1999 Jun;3(3):207-12.


Objective: The objective of this chart review was to determine the frequency of transfusion and prevalence of anemia (hemoglobin result < 100 g/L) in patients receiving chemotherapy.

Design: This study was a retrospective review of medical charts.

Setting: Patients receiving chemotherapy were included from 12 tertiary care comprehensive cancer centres across Canada.

Main outcome measure: The primary study outcome measure was red blood cell transfusion rate, controlling for patient variables.

Results: The 616 patients included had started chemotherapy in January-June 1992. For each subject, data collection finished 4 weeks after the end of the first regimen or after a maximum follow-up period of 26 weeks. Seventy-two patients (12%; 95% confidence interval 9.5% to 14.5%) were transfused for anemia (reasons other than blood loss), and 28% (95% confidence interval 24.5% to 31.5%) of the subjects were anemic during treatment. The univariate analyses of transfusion for anemia yielded significant associations with prognostic factors. In the multivariate analyses, platinum (odds ratio [OR] = 6.69) and anthracycline (OR = 3.56) chemotherapy, baseline hemoglobin (OR = 0.96) and disease stage (OR = 1.72) were statistically significant contributors.

Conclusion: In this patient cohort, red blood cell transfusion was infrequent (12%). However, patient groups at high risk of transfusion could be identified, with platinum-based chemotherapy being the most significant contributing factor. The information obtained from this multicentre study may prove helpful in developing supportive care guidelines for the management of chemotherapy-related anemia requiring transfusion.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Anemia / chemically induced
  • Anemia / epidemiology*
  • Anemia / therapy*
  • Antineoplastic Agents / adverse effects*
  • Canada / epidemiology
  • Cohort Studies
  • Erythrocyte Transfusion / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Neoplasms / drug therapy*
  • Odds Ratio
  • Prevalence
  • Retrospective Studies


  • Antineoplastic Agents