Background: Fatigue has been reported to be associated with anemia in patients receiving cancer
treatment. Treatment of anemia such as erythropoietin has been reported to decrease fatigue
in these patients.
Objective: To investigate the correlation between anemia and fatigue intensity in patients
with advanced cancer receiving palliative care.
Methods: We reviewed medical charts of 177 consecutive outpatients seen by our palliative
care specialists. Information of fatigue intensity and hemoglobin level was collected.
Results: Among 147 (83%) evaluable patients, the median hemoglobin level was 11.6 g/dL
(range, 7.5–16.1). Eighty-two (56%) patients had a hemoglobin level 12 g/dL or less, whereas
125 (85%) had 10 g/dL or more. The median fatigue score in patients with a hemoglobin level
10 g/dL or more and 10 g/dL or less was 6 (range, 4–8) and 7 (range, 5–8), respectively (p =
0.048). The median fatigue score in patients with a hemoglobin level 12 g/dL or more and 12
g/dL or less was 6 (range, 4–7) and 6 (range, 4–8), respectively (p > 0.5). Spearman's rank correlation
coefficient showed a significant association only between the hemoglobin level and
the albumin level (r = 0.52, p < 0.0001). Hemoglobin level did not show a significant correlation
with fatigue although there was a trend (p = 0.09). In a multivariate regression analysis
of the intensity of fatigue and other clinical variables, three variables remained significant in
the reverse elimination analysis: depression (p = 0.0067), albumin level (p = 0.0079), and sensation
of well-being (p = 0.0569). The overall explained variance for this model was 0.22.
Conclusion: Our findings suggest that anemia is not one of the major contributors to fatigue
in patients with cancer receiving palliative care.
