Background: Cancer-related anemia (CRA) occurs in a significant proportion of cancer patients and affects disease progression, treatment efficacy, and survival. The chronic inflammatory state associated with cancer is believed to be a major cause of CRA. Tumor necrosis factor alfa (TNF-α) plays a crucial role in the pathogenesis of cancer-related anemia (CRA).
Aim: To evaluate TNF-α level, erythropoietin (EPO), and iron status in children with newly diagnosed solid tumors.
Methods: This cross-sectional study included 42 children with newly diagnosed solid tumors, recruited from the Pediatric Oncology Clinic at Ain Shams University Children's Hospital by random sampling during the period from June 2022 to February 2023. Twenty-five age- and sex-matched children were enrolled as hospital-based controls. All study participants were subjected to full history taking, through clinical examination and assessment of CBC, iron profile, serum TNF-α and EPO levels.
Results: Out of 42 cancer patients, 48%(n=20) were non-anemic (group 1) and, 52%(n=22) were anemic (group 2) with 54.5% (n=12) having functional iron deficiency (FID) anemia. In both patient groups, significantly higher TNFα and lower EPO levels were found compared to controls. Among the anemic group, TNFα negatively correlated with both EPO level and reticulocyte count (p= 0.024) and (p= 0.211) respectively.
Conclusion: Patients with CRA have evident state of FID anemia, elevated TNFα and reduced EPO levels.