Publikation des Studiedesigns:
Link, H., Kerkmann, M., & Holtmann, L. (2021). Anämie – Diagnostik und Therapie bei soliden Tumoren und malignen Lymphomen. Forum, 36(4), 326-327. doi:10.1007/s12312-021-00948-7

Die Studie ist abgeschlossen, Publikationen erfolgten 2022 auf den Kongressen von ESMO, DGHO und AIO. Die Publikation ist in Vorbereitung.

DGHO Kongress 2022 Wien, Vortrag, Abstract
Qualitätssicherung zum Anämiemanagement bei Patientinnen und Patienten mit soliden Tumoren und hämatologischen Neoplasien, Seite 251

Qualitätssicherung zum Anämiemanagement bei Patientinnen und Patienten mit soliden Tumoren und hämatologischen Neoplasien
Quality Assurance Initiative on Anemia Management in Patients with Solid Tumors and Hematologic Neoplasms
Hartmut Link, Prof. Dr.1
Markus Kerkmann, MA2
Laura Holtmann, MSc2
Arbeitsgemeinschaften Internistische Onkologie (AIO) und Supportive Maßnahmen in der Onkologie (AGSMO) in der Deutschen Krebsgesellschaft (DKG) – AIO-SUP-0121

1 Hematology, Oncology - Kaiserslautern, Finkenhain 8, D- 67661 Kaiserslautern
2 MMF GmbH, Lindberghweg 132, D-48155 Münster

Anemia is a frequent complication in patients with breast cancer (BC), gastrointestinal tumors (GC), lung cancer (LC) and malignant lymphomas (ML). Guidelines (GL) on anemia management (ESMO; DGHO) provide dedicated algorithms for diagnosis and treatment of anemia. Aim of the study was to analyze GL adherence (GLAD) in Germany.
This was a retrospective sample analysis representative for practices and hospitals in Germany. Data on tumor treatments and anemia management was collected from records of cancer patients (pts) with grade ≥ 2 anemia diagnosed between January and June 2021.
Definition of diagnosis GLAD score (GLAD-D): 2 points (pt) for full adherence, 1 pt for a lack in differential diagnosis on iron metabolism. 0 pt if differential diagnosis is missing. Treatment GLAD score (GLAD-T): 2 pt for full adherence to GL recommendation in relation to diagnosis. 1 pt for indicated red blood cells (RBC) as only anemia therapy or no therapy in pts with Hb ≥8g/dl. 0 pt for RBC without indication, p.o. iron substitution under inflammatory conditions (CRP>5mg/l) or vitamin B12 or folate deficiency without substitution.
Data from 1046 pts (311 BC, 371 GC, 260 LC, 104 ML) were collected from 143 centers. 996 (92.4%) pts were treated with medical tumor therapy and 317 (30.3%) received radiotherapy. Hb-values at diagnosis of anemia were 8-10 g/dl in 899 (85.9%) pts, 6-8g/dl in 135 (12.9%) and <6g/dl (1.2%) in 12 pts. 456 pts were treated with RBC (43.6%), 198 (18.9%) with iron substitution, 106 (10.1%) with ESA and 60 (5.7%) with vitamin B12. 60.6% of the pts with iron substitution were treated i.v. and 39.4% p.o. 37.5% of pts with RBC had no indication in the sense of the restrictive RBC policy recommended by the GLs.
GLAD was poor in diagnosis and treatment: GLAD-D was 2 pt in 310 pts (29.6%) of pts, 1 pt at 168 (16.1%) and 0 pt in 568 (54.3%) pts. GLAD-T was 2 pt in 270 pts (25.8%), 1 pt in 310 (29.6%) and 0 pt in 466 (44.6%).
Higher GLAD-D correlated significantly to a higher GLAD-T (τB 0.262, p<0.001). Full GLAD-T (2 pt) was significantly associated with a greater Hb increase than GLAD-T 0/1 (p<0.001) at 28 days (10.2 vs. 9.7 g/dl) and at 2 months (10.4 vs 9.9 g/dl).
Pts with anemia management as per GL had a significantly stronger Hb-increase. GLAD is poor in Germany, especially concerning the too liberal transfusion policy and the lack of differential diagnostics of iron metabolism.
NCT05190263, Grant: Pharmacosmos