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2000
Volume 25, Issue 5
  • ISSN: 1568-0096
  • E-ISSN: 1873-5576

Abstract

Background

Solid pediatric tumors refer to cancers that affect children and adolescents, and they present unique challenges due to their distinct biological characteristics and their vulnerability to young patients. This study aims to shed light on addressing anemia and the causes of anemia in patients with solid pediatric tumors.

Materials and Methods

This retrospective cohort comprised 200 healthy children as controls and 235 patients with solid tumors. The study was conducted at first Affiliated Hospital of Zhengzhou University between January 2020 and June 2023. We evaluated different parameters of blood components in controls and patients with solid tumors such as medulloblastoma, neuroblastoma, rhabdomyosarcoma, germ cell tumors, hepatoblastoma and nephroblastoma before and patients with only these tumors 3 weeks after the first cycle of chemotherapy. Further, we evaluated the relationship between serum ferritin and the weight of patients and assessed the relationship between anemia and metastasis to the bone marrow in patients with neuroblastoma and hepatoblastoma.

Results

We observed various combinations of derangements in blood parameters such as hemoglobin, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, hematocrit, red cell distribution width, white blood cells, and platelet in medulloblastoma, neuroblastoma, rhabdomyosarcoma, germ cell tumors, hepatoblastoma and nephroblastoma before and 3 weeks after first cycle of chemotherapy. We found a significant correlation between serum ferritin levels and weight in neuroblastoma patients who are ≤ 2 years (p = 0.022). Involvement of tumor cells in bone marrow correlates with decreased Hb level in both neuroblastoma (CI = 93.21-106.68, p = 0.001) and hepatoblastoma (CI = 113.36-121.00, p = 0.001).

Conclusion

Anemia may manifest as an early symptom in neuroblastoma, hepatoblastoma, and nephroblastoma. Also, anemia may be worse in patients with neuroblastoma and hepatoblastoma after chemotherapy and might warrant anemia therapy.

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2024-07-05
2025-04-22
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References

  1. SunuwarD.R. SinghD.R. PradhanP.M.S. ShresthaV. RaiP. ShahS.K. AdhikariB. Factors associated with anemia among children in South and Southeast Asia: A multilevel analysis.BMC Public Health202323134310.1186/s12889‑023‑15265‑y36793012
    [Google Scholar]
  2. AlFarisN. ALTamimiJ. AlKehayezN. AlMushawahF. AlNaeemA. AlAmriN. AlMudawahE. AlsemariM. AlzahraniJ. AlqahtaniL.II AlenaziW. AlmutebA.II AlotibiH. Prevalence of anemia and associated risk factors among non-pregnant women in Riyadh, Saudi Arabia: A cross-sectional study.Int. J. Gen. Med.20211476577710.2147/IJGM.S29945033707967
    [Google Scholar]
  3. RuggieroA. RiccardiR. Interventions for anemia in pediatric cancer patients.Med. Pediatr. Oncol.200239445145410.1002/mpo.1018412203662
    [Google Scholar]
  4. FurrerR. JauchA.J. Nageswara RaoT. DilbazS. RheinP. SteurerS.A. RecherM. SkodaR.C. HandschinC. Remodeling of metabolism and inflammation by exercise ameliorates tumor-associated anemia.Sci. Adv.2021737eabi485210.1126/sciadv.abi485234516881
    [Google Scholar]
  5. CamaschellaC. New insights into iron deficiency and iron deficiency anemia.Blood Rev.201731422523310.1016/j.blre.2017.02.00428216263
    [Google Scholar]
  6. CullisJ.O. FitzsimonsE.J. GriffithsW.J.H. TsochatzisE. ThomasD.W. Investigation and management of a raised serum ferritin.Br. J. Haematol.2018181333134010.1111/bjh.1516629672840
    [Google Scholar]
  7. MendeN. LaurentiE. Hematopoietic stem and progenitor cells outside the bone marrow: where, when, and why.Exp. Hematol.202110491610.1016/j.exphem.2021.10.00234687807
    [Google Scholar]
  8. DainiakN. KulkarniV. HowardD. KalmantiM. DeweyM.C. HoffmanR. Mechanisms of abnormal erythropoiesis in malignancy.Cancer19835161101110610.1002/1097‑0142(19830315)51:6<1101::AID‑CNCR2820510622>3.0.CO;2‑G6821869
    [Google Scholar]
  9. GilreathJ.A. StenehjemD.D. RodgersG.M. Diagnosis and treatment of cancer‐related anemia.Am. J. Hematol.201489220321210.1002/ajh.2362824532336
    [Google Scholar]
  10. JelkmannW. Erythropoietin: Structure, control of production, and function.Physiol. Rev.199272244948910.1152/physrev.1992.72.2.4491557429
    [Google Scholar]
  11. IwafuchiH. The histopathology of bone marrow failure in children.J. Clin. Exp. Hematop.2018582688610.3960/jslrt.1801829998978
    [Google Scholar]
  12. TombalB. LecouvetF. Modern detection of prostate cancer’s bone metastasis: Is the bone scan era over?Adv. Urol.201220121810.1155/2012/89319322013439
    [Google Scholar]
  13. GasparB.L. SharmaP. DasR. Anemia in malignancies: Pathogenetic and diagnostic considerations.Hematology2015201182510.1179/1607845414Y.000000016124666207
    [Google Scholar]
  14. FanH. SuY. DuanC. ZhaoQ. WangX. ZhuS. ZhaoW. JinM. MaX. Iron deficiency in children at the time of initial neuroblastoma diagnosis.Pediatr. Investig.202041172210.1002/ped4.1215632851337
    [Google Scholar]
  15. SchwartzRN Anemia in patients with cancer: incidence, causes, impact, management, and use of treatment guidelines and protocols.Am J Health Syst Pharm2007643 Suppl 2S5S1310.2146/ajhp060601
    [Google Scholar]
  16. MadedduC. GramignanoG. AstaraG. DemontisR. SannaE. AtzeniV. MacciòA. Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach.Front. Physiol.20189129410.3389/fphys.2018.0129430294279
    [Google Scholar]
  17. Recommendations for prevention and treatment of iron deficiency and iron deficiency anemia in children.Chin. j. pediat.2008467502504
    [Google Scholar]
  18. XiaoZ. MurakhovskayaI. Development of new drugs for autoimmune hemolytic anemia.Pharmaceutics2022145103510.3390/pharmaceutics1405103535631621
    [Google Scholar]
  19. LudwigH. MüldürE. EndlerG. HüblW. Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia.Ann. Oncol.20132471886189210.1093/annonc/mdt11823567147
    [Google Scholar]
  20. RayburnE. EzellS.J. ZhangR. Anti-inflammatory agents for cancer therapy.Mol. Cell. Pharmacol.200911294310.4255/mcpharmacol.09.0520333321
    [Google Scholar]
  21. VarlottoJ. StevensonM.A. Anemia, tumor hypoxemia, and the cancer patient.Int. J. Radiat. Oncol. Biol. Phys.2005631253610.1016/j.ijrobp.2005.04.04916111569
    [Google Scholar]
  22. LudwigH Van BelleS Barrett-LeeP BirgegårdG BokemeyerC GascónP The European Cancer Anaemia Survey (ECAS): A large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients.Europ. j. canc.2004401522932306
    [Google Scholar]
  23. BirgegårdG. AaproM.S. BokemeyerC. DicatoM. DringsP. HornedoJ. KrzakowskiM. LudwigH. PecorelliS. SchmollH.J. SchneiderM. SchrijversD. ShashaD. van BiesenS. Cancer-related anemia: Pathogenesis, prevalence and treatment.Oncology200568Suppl. 131110.1159/00008312815855811
    [Google Scholar]
  24. RanganathanS. Lopez-TerradaD. AlaggioR. Hepatoblastoma and pediatric hepatocellular carcinoma: An update.Pediatr. Dev. Pathol.2020232799510.1177/109352661987522831554479
    [Google Scholar]
  25. HiyamaE. Pediatric hepatoblastoma: Diagnosis and treatment.Transl. Pediatr.20143429329926835349
    [Google Scholar]
  26. TolbertV.P. MatthayK.K. Neuroblastoma: Clinical and biological approach to risk stratification and treatment.Cell Tissue Res.2018372219520910.1007/s00441‑018‑2821‑229572647
    [Google Scholar]
  27. RileyR.S. WilliamsD. RossM. ZhaoS. ChesneyA. ClarkB.D. Ben-EzraJ.M. Bone marrow aspirate and biopsy: A pathologist’s perspective. II. interpretation of the bone marrow aspirate and biopsy.J. Clin. Lab. Anal.200923525930710.1002/jcla.2030519774631
    [Google Scholar]
  28. HernandezA.M. Peripheral blood manifestations of lymphoma and solid tumors.Clin. Lab. Med.200222121525210.1016/S0272‑2712(03)00073‑811933576
    [Google Scholar]
  29. GallagherP.G. Anemia in the pediatric patient.Blood2022140657159310.1182/blood.202000647935213686
    [Google Scholar]
  30. QuinnJ.J. AltmanA.J. The multiple hematologic manifestations of neuroblastoma.J. Pediatr. Hematol. Oncol.19791320120610.1097/00043426‑197923000‑00002543514
    [Google Scholar]
  31. MaciaszekJ.L. OakN. NicholsK.E. Recent advances in Wilms’ tumor predisposition.Hum. Mol. Genet.202029R2R138R14910.1093/hmg/ddaa09132412586
    [Google Scholar]
  32. DavidsonA. HartleyP.S. ShuttleworthM.H.G. Erythrocytosis and iron deficiency anemia in Wilms tumor.J. Pediatr. Hematol. Oncol.200527950210.1097/01.mph.0000181429.71176.6116189446
    [Google Scholar]
  33. KaiY. YingP. BoY. FurongY. JinC. JuanjuanF. PingpingT. FasuZ. Red blood cell distribution width-standard deviation but not red blood cell distribution width-coefficient of variation as a potential index for the diagnosis of iron-deficiency anemia in mid-pregnancy women.Open Life Sci.20211611213121810.1515/biol‑2021‑012034761112
    [Google Scholar]
  34. SultanaG.S. HaqueS.A. SultanaT. AhmedA.N. Value of red cell distribution width (RDW) and RBC indices in the detection of iron deficiency anemia.Mymensingh Med. J.201322237037623715364
    [Google Scholar]
  35. AulakhR. SohiI. SinghT. KakkarN. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia.Indian J. Pediatr.200976326526810.1007/s12098‑009‑0014‑419205647
    [Google Scholar]
  36. WagnerL.M. GarrettJ.K. BallardE.T. HillD.A. PerryA. BiegelJ.A. CollinsM.H. Malignant rhabdoid tumor mimicking hepatoblastoma: A case report and literature review.Pediatr. Dev. Pathol.200710540941510.2350/06‑08‑0155.117929989
    [Google Scholar]
  37. YamaguchiH. IshiiE. HayashidaY. HirataY. SakaiR. MiyazakiS. Mechanism of thrombocytosis in hepatoblastoma: A case report.Pediatr. Hematol. Oncol.199613653954410.3109/088800196090308698940737
    [Google Scholar]
  38. HwangS.J. LuoJ.C. LiC.P. ChuC.W. WuJ.C. LaiC.R. ChiangJ.H. ChauG.Y. LuiW.Y. LeeC.C. ChangF.Y. LeeS.D. Thrombocytosis: A paraneoplastic syndrome in patients with hepatocellular carcinoma.World J. Gastroenterol.200410172472247710.3748/wjg.v10.i17.247215300887
    [Google Scholar]
  39. DanzingerS. FügerlA. PfeiferC. BernathovaM. Tendl-SchulzK. SeifertM. Anemia and response to neoadjuvant chemotherapy in breast cancer patients.Cancer Invest.2021396-745746510.1080/07357907.2021.192816633961512
    [Google Scholar]
  40. XuJ NiC MaC ZhangL JingX LiC Association of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio with ER and PR in breast cancer patients and their changes after neoadjuvant chemotherapy.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico.2017198989996
    [Google Scholar]
  41. CaroJ.J. SalasM. WardA. GossG. Anemia as an independent prognostic factor for survival in patients with cancer.Cancer200191122214222110.1002/1097‑0142(20010615)91:12<2214::AID‑CNCR1251>3.0.CO;2‑P11413508
    [Google Scholar]
  42. GajendraS. SharmaR. Cytomorphological evaluation of non-haematopoietic malignancies metastasizing to the bone marrow.Am. J. Blood Res.202313111136937461
    [Google Scholar]
  43. YangH. HeF. YuanT. XuW. CaoZ. Clinical features and treatment of bone marrow metastasis.Oncol. Lett.202326233210.3892/ol.2023.1391837415634
    [Google Scholar]
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