CAUSES OF ANEMIA IN CANCER AND THE EFFECT OF CHEMOTHERAPHY ON ERYTHROPOIETIN LEVELS

Cancer is the second cause of death after heart diseases and takes part a ratio of 22.3% in the overall number of death. Throughout last years, the incidence of cancer is seen to be increasing. Anemia is seen in more than 90% of patients having cancer, during their life time. Diagnosis and treatment of cancer related anemia both increases the quality of life of the patient and the survival time. In our study, 42 patients who have not received chemotherapy and having cancer related anemia, 20 of them who had received chemotheraphy were enrolled for examining causes of cancer related anemia. In the patients, 20 healthy individuals and 20 cancer patients without anemia being control group, the levels of erythropoietin were compared. Out of the patients who did not receive chemotherapy; 27 patients (64.2%) had anemia of chronic disease, 10 patients (23.8%) had iron deficiency anemia, 6 patients (14.2%) had vitamin B12 deficiency anemia, 4 patients (9.5%) had folic asid deficiency anemia, 4 patients (9.5%) had blood loss anemia, 3 patients (7.1 %) had hemolytic anemia. Out of 20 patients who were evaluated after chemotherapy, 17 patients (85%) had anemia of chronic disease, 2 patients (10%) had iron deficiency anemia, 1 patient (5%) had folic acid deficiency anemia. The erytropoietin levels of anemic patients who did not receive chemotherapy (16.36±17.84) were very significantly higher than the levels of anemic patients who received chemotherapy (2.93±4.23) (p<0.001). As a conclusion, in our country, nearly half the patients with cancer related anemia who receive chemotherapy, have iron or vitamin deficiency. These deficiencies are especially seen in gastrointestinal cancers. Replacement of these substances is easy and cheap and on the other hand increases the survival.

Keywords: cancer, anemia, erythropoietin