Predictors of hemoglobin decline in non-metastatic prostate cancer patients on androgen deprivation therapy: a matched cohort study
- 16 October 2010
- journal article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 19 (11), 1815-1821
- https://doi.org/10.1007/s00520-010-1023-6
Abstract
The extent and severity of hemoglobin decline after the initiation of androgen deprivation therapy (ADT) is unclear, and predictors of hemoglobin decline in older men with prostate cancer (PC) are not well-characterized. Three cohorts were recruited in this prospective study to evaluate the impact of ADT and other factors on hemoglobin decline. Cohorts included ADT users initiating continuous ADT, PC controls, and healthy controls, matched on age and education. All patients with PC had non-metastatic disease. Univariate and multivariable associations between changes in hemoglobin over 12 months and baseline characteristics were evaluated using linear regression models. We included 250 men (mean age 69 years). The baseline mean hemoglobin was 141 g/L in ADT users, 144 g/L in PC controls, and 149 g/L in healthy controls (p < 0.001). Over 12 months, the mean hemoglobin level declined in ADT users by 8.9 g/L, compared to 0.56 and 2.03 g/L among PC controls and healthy controls, respectively (p < 0.001). Statistically significant predictors of greater hemoglobin decline included ADT use (p < 0.001), lower activities of daily living score (p < 0.001), higher Charlson comorbidity score (p = 0.02), higher baseline hemoglobin level (p < 0.001), and non-White race (p = 0.04) but not age (p = 0.50). In men with non-metastatic prostate cancer, ADT was independently associated with a decline in hemoglobin level over 12 months. Other predictors of declining hemoglobin included comorbidity, functional status, baseline hemoglobin level, and race. These findings may help clinicians identify patients starting ADT who would benefit from closer hemoglobin monitoring.Keywords
This publication has 26 references indexed in Scilit:
- Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus StudyCMAJ : Canadian Medical Association Journal, 2009
- Anemia of chronic disease: A harmful disorder or an adaptive, beneficial response?CMAJ : Canadian Medical Association Journal, 2008
- Does androgen‐deprivation therapy accelerate the development of frailty in older men with prostate cancer?Cancer, 2007
- Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer: 2007 Update of an American Society of Clinical Oncology Practice GuidelineJournal of Clinical Oncology, 2007
- The prognostic value of hemoglobin change after initiating androgen‐deprivation therapy for newly diagnosed metastatic prostate cancerCancer, 2006
- Managing Complications of Androgen Deprivation Therapy for Prostate CancerUrologic Clinics of North America, 2006
- Anemia and Recovery from Disability in Activities of Daily Living in Hospitalized Older PersonsJournal of the American Geriatrics Society, 2006
- No Adjustments Are Needed for Multiple ComparisonsEpidemiology, 1990
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987
- Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily LivingThe Gerontologist, 1969