|
The prognostic effect of
hemoglobin levels on survival for patients with high-grade gliomas
B. E. Lally, J. M. Colasanto, J. P. S. Knisely
Yale University - School of Medicine, New Haven, CT
Background.
We conducted a retrospective study of patients with high
grade glioma treated with radiotherapy (XRT) at our institution to evaluate the
prognostic impact of hemoglobin (HGB) levels on overall survival.
Methods.
Between 1992 and 2001, 97 adult patients with glioblastoma
multiforme (GBM) and 24 patients with anaplastic astrocytoma (AA) were treated
at our institution with XRT and had a HGB available for review.
The HGB used for this analysis was the peak HGB available, whether obtained at
the initiation of XRT or obtained at some time during XRT.
These peak HGB values ranged from 8.8 gm/dl – 16.6 gm/dl.
The median was 13.40 gm/dl and the standard deviation was 1.5136.
Two groups were created for subsequent analysis; patients with HGB > 13.5
gm/dl and patients with hemoglobin <13.5 gm/dl.
The primary endpoint was overall survival calculated from the time of initial
surgery.
Results.
The median follow-up was 10 months, with a range of 1-120
months.
Cox stepwise regression analysis was performed on the cohort.
Age was found to be the most significant variable with older patients having a
poorer prognosis (RR = 1.049; 95% CI = 1.033-1.065; P<0.0001).
HGB was also found to be prognostic, with patients failing to reach a peak HGB
of 13.5 gm/dl having a poorer prognosis (RR = 1.975; 95% CI = 1.231-3.167;
P<0.0485).
Patients with GBM pathology did worse than those with AA pathology (RR = 2.031;
95% CI = 1.132-3.645; P=0.0779).
Lastly, patients who received either a subtotal or gross total surgical
resection had a better survival than those patients treated with biopsy only (RR
= 1.592; 95% CI = 1.021-2.483; P=0.0553).
Conclusions.
In patients with high grade gliomas, elevated hemoglobin
levels may influence clinical outcome.
This data may provide an additional prognostic factor useful to physicians, and
potentially offer a means of improving therapy for these patients.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-004322,00.asp
|
