A randomized trial of anemia correction with two different hemoglobin targets in the first-line chemotherapy of advanced gastric cancer

Se Hoon Park, Eunmi Nam, Soo Mee Bang, Eun Kyung Cho, Dong Bok Shin, Jae Hoon Lee

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12 Scopus citations


Purpose: To evaluate if raising baseline and maintaining hemoglobin (Hb) levels with red blood cell (RBC) transfusion could improve the outcomes of chemotherapy for advanced gastric cancer (AGC). Methods: Patients were randomized to receive RBC transfusion to maintain their Hb levels ≥10 g/dl (arm 1) or ≥12 (arm 2) before the start of their 5-fluorouracil-based first-line chemotherapy. Objective response, KPS and quality of life (QOL) data were measured. Results: For 87 patients enrolled, mean baseline Hb was 10.1 g/dl, and 54 patients received RBC prior to chemotherapy initiation. Despite transfusion, we failed to maintain the Hb level above the predefined target range. Eighteen patients experienced brief and reversible adverse events during transfusion, including two patients with acute pulmonary edema. KPS was improved from baseline to post-chemotherapy in both arms. QOL data showed improvement in some symptom scores, but there was no difference in the QOL scores between the two arms at baseline and all four cycles of treatment. Similar response rates were observed in both arms (arm 1, 30%; arm 2, 35%). Both arms showed similar chemotherapy duration (3.8 and 4.1 months, respectively), progression-free survival (4.0 and 4.1 months) and overall survival (9.9 and 9.3 months). Conclusions: Red blood cell transfusion achieving Hb level above 10 g/dl might contribute to the improvement of the KPS and QOL seen in patients with AGC. The observation of equivalent outcomes at the two target Hb levels supports the feasibility of anemia correction to Hb 10 g/dl, which merits further evaluation.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalCancer Chemotherapy and Pharmacology
Issue number1
StatePublished - Jun 2008

Bibliographical note

Funding Information:
Acknowledgments This study was Wnancially supported by an unrestricted research grant from Gachon University Gil Medical Center, Incheon, South Korea. We thank to Dal Mo Yang, MD (Department of Radiology, Kyunghee University, Seoul, South Korea) for the review of all imaging studies. We also thank to Pil Whan Park, MD (Department of Laboratory Medicine, Gachon University, Incheon, South Korea) for assistance with alloantibody tests.


  • Anemia
  • Chemotherapy
  • Stomach cancer
  • Transfusion


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