Haematological and Urinalysis Parameters among Anaemic Patients with Gynaecological and Surgical Cancers at a Tertiary Hospital in Nigeria

Abstract

Background: Anaemia is a common complication of cancer, yet the major causes of cancer-related anaemia particularly in our setting remains unclear. This study assessed haematological and urinalysis parameters among anaemic patients with gynaecological and surgical cancers to better understand the aetiology of cancer- related anaemias.

Methods: This hospital-based descriptive cross-sectional study was conducted at the University of Benin Teaching Hospital between March 2016 and May 2017. Ninety-four anaemic patients (49 with surgical cancers, 45 with gynaecological cancers) were consecutively recruited. Laboratory assessments included full blood count, reticulocyte count, peripheral blood film, bilirubin assay, urinalysis and antibody screening via direct and indirect antiglobulin (Coombs) tests.

Results: The mean age of participants was 52.3 ± 1.4 years while the mean haemoglobin ± SEM of all participants was 9.76±0.15 g/dl. The majority of anaemia cases were mild or moderate, with no statistically significant difference between cancer types. Antibody screening revealed no positive cases (0.0%) for either direct or indirect Coombs tests. Burr cells, suggesting renal dysfunction, were found in 11(23.5%) participants. Most anaemias were microcytic-hypochromic. Urinalysis findings showed a subset of patients had proteinuria (23 (24.5%) participants) or haematuria (20 (11.3%) participants), particularly those with burr cells—supporting possible renal impairment.

Conclusion: Cancer related anaemias (CRA) are a leading cause of hospitalization amongst cancer patients and the use of basic haematological and urinalysis parameters can serve as a cheap and effective screening tool to determine the aetiology of CRAs. The inappropriate reticulocyte response, the red cell morphologic findings on PBF examination, evidence of proteinuria and haematuria on urine analysis, and the absence of red cell autoantibodies all suggest that diverse mechanisms, such as chronic inflammation, nutritional deficiencies, bone marrow infiltration, or renal dysfunction, are more likely to underlie anaemia in these patients. It also almost rules out an autoimmune basis to CRAs in solid tumours.