impact of recently published negative erythropoiesis-stimulating agent studies on the clinical management of cancer-related anemia at a single center

Anemia in cancer patients is common, but often under-recognized and under-treated. Erythropoiesis stimulating agents [ESAs] are widely used to prevent and treat cancer and chemotherapy-related anemia, but recent studies suggest a negative impact on disease progression and survival associated with their use. This retrospective study describes the prevalence of anemia in cancer patients and recent trends in its management given the negative studies. All consecutive adult cancer patients [n=959] admitted to regular medical units over one year were reviewed. Patients with a hemoglobin [Hb] value<12 g/dL on admission were considered anemic. Information on the primary tumor, main reasons for admission and treatment given were collected. At the time of enrollment, anemia was detected in 755 [78.7%] patients. The mean Hb value for anemic patients was 9.5 g/dL. Prevalence and severity of anemia varied according to tumor type and reason for admission. The majority [68.6%] of the anemic patients were not offered treatment. The mean Hb value at which treatment was started was 8.0 g/dL. Anemia treatment was related to its severity; treatment rates were 94.4%, 32.9%, and 5.0% in patients with severe, moderate and mild anemia, respectively [P<.0001]. Blood transfusion was used the most while ESAs were rarely used. Length of hospital stay was affected by the presence of anemia [7.2 days in anemic patients vs. 4.85 days in nonanemic patients] [P<.001]. Blood transfusion was used the most for cancer-related anemia, while ESAs were rarely used. The majority of patients with moderate anemia were not treated, including patients on active chemotherapy. Better guidelines addressing anemia management in this subgroup of patients are highly needed

Prevalence of hepatitis C virus antibodies among blood donors in northern Jordan

Hepatitis C Virus [HCV] remains the most common cause of transfusion-related hepatitis in the world. Despite the accurate screening methods introduced after the discovery of the virus about two decades ago, blood and blood products transfusion remains an important source of HCV infection in Jordan. The worldwide prevalence of HCV among blood donors is variable, ranging between 0.17 and 20%. The main objective of this study was to determine the prevalence of positive serology for HCV among blood donors in the population of Northern Jordan. The prevalence of different HCV genotypes among positive serology individuals was a secondary objective of the study. From January 2004 till June 2006, a total of 14,236 individuals [13666 males and 570 females] donated blood at King Abdullah University Hospital. A third-generation Enzyme- Linked Immuno-Sorbent Assay [ELISA] test system using the commercial Diasorin kit, ETI-AB-HCVK- 4[N0146, No 147] which was used to screen all donors for antibodies to HCV. The test was performed strictly as per the manufacturer's instructions. Data were collected from the blood bank database. Samples of HCV positive serology and detectable HCV RNA were submitted to genotyping using Real Time PCR. [MX 4000] method. A total of 29 blood donors [27 males, 2 females] were tested positive for anti-HCV antibodies, with an overall prevalence of 0.20%. The seroprevalence in females was approximately the double of that of males [0.35% vs 0.19%]. The most prevalent HCV genotype was type 4. This study indicates that the prevalence of HCV among blood donors in the North of Jordan is lower than that in other regions of the country. Overall, our national prevalence of HCV among healthy blood donors [0.2%-0.79%] is concordant with the results of epidemiological studies from the Western World [0.17-0.1.5%]. The most prevalent HCV genotype in this cohort of individuals was genotype 4