Prevalence of iron and Vitamin B 12 deficiencies and inflammatory anemia in treatment-naive patients with cancer: A cross-sectional study

Abstract

Background: Anemia in patients with cancer has been associated with poor outcomes. There are scarce data on the prevalence of iron and Vitamin B 12 deficiencies and inflammatory anemia among treatment-naive patients in the Indian setting. Objectives: In this study, we aimed to evaluate the prevalence of anemia and iron and Vitamin B 12 deficiencies along with inflammation in treatment-naive patients. Materials and Methods: This single-center cross-sectional study was conducted at the Indira Gandhi Institute of Medical Sciences (Patna, India) from July 2019 to December 2019. All patients registered in the Medical Oncology Department were offered testing for iron profile and serum Vitamin B 12 and serum ferritin levels. Anemia was defined as hemoglobin level<11 g/dL. Transferrin saturation<20%, serum ferritin >300 mg/L, and Vitamin B 12 level<200 pg/ml were the 'cutoffs' used to define iron deficiency, inflammation, and Vitamin B 12 deficiency, respectively. Data were analyzed using descriptive statistics in the SPSS version 17.0. Pearson's Chi-squared test and odds ratio were used to measure the strength of association of anemia with the variables. Results: We included 311 patients in the study, of which 167 (54%) were men. The median age of the cohort was 52 ± 15.9 years (range, 18-84). The prevalence of anemia was found to be 61% ± 2.7 (95% confidence interval, 55-66%). The mean hemoglobin level of the cohort was 9.86 ± 2.08 g/dl (range, 3-16). Of 311 patients, 21 (7%) had severe anemia (hemoglobin<6.9 g/dl). Iron deficiency, inflammation, and Vitamin B 12 deficiency were noted in 135/189 (71%), 61/189 (32%), and 89/189 (47%) anemic patients, respectively. Over 70% of the patients with gastrointestinal, gynecological, and lung cancers had an underlying iron deficiency. Conclusions: Two-thirds of our Indian patients with cancer are iron deficient, whereas half and one-third of them have Vitamin B 12 deficiency and inflammation, respectively.