***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: An analysis of prognostic factors in small cell lung cancer has been carried out using data from 371 patients treated with identical chemotherapy  in the context of a large prospect ively r and omized clinical trial . Prognosis was shown to be strongly correlated with initial performance status , disease extent , and routine biochemical tests at the time of diagnosis . Plasma albumin , plasma sodium , alkaline phosphatase , and gamma-glutamyl transpeptidase were all predictive of survival . An initial hemoglobin of less than 11 g/dl was also predictive , but age , sex , and initial WBC count were not . A multiple regression analysis identified performance status , plasma alkaline phosphatase , plasma sodium , disease extent , and plasma albumin as contributing independently to survival . Using these parameters , three prognostic groupings could be defined . The combination of performance status and the biochemical values more closely predicted survival than categorization on the basis of disease extent defined by clinical , radiological , and scanning criteria . Response to chemotherapy  was strongly correlated with these prognostic groupings . A much higher response rate occurred in patients in the best prognostic category in whom the tumor mass is assumed to be smaller . These results provide a simple basis for predicting prognosis in small cell lung cancer and indicate that the better prognosis in chemotherapy responders is not solely due to the treatment OBJECTIVES Blood transfusion has been shown to have deleterious effect on lung cancer survival , but little data are available that assess whether leukocyte-depleted ( LD ) blood has a similar adverse effect . Our institution has been using LD red cells since 2001 . We sought to determine whether LD blood has an effect on survival after resection of early-stage lung cancer . METHODS From a prospect i ve data base , we evaluated all patients with pathologic stage I non-small cell lung cancer . Patients receiving LD blood  were compared with those receiving no transfusion .  Survival was estimated using the Kaplan-Meier method and compared using the log-rank test . Multivariate analysis by Cox regression was used to identify independent risk factors affecting survival . RESULTS From 2001 to 2009 , 361 patients were evaluated ; 63 received LD red cell cell transfusion and 298 received no transfusion .  Median follow-up was 48 months . Disease-free survival ( P < .001 ) and overall survival ( P < .001 ) were worse in patients receiving LD blood . Stratifying for stage , disease-free survival continued to be worse with transfusion for stage IA ( P = .002 ) and IB ( P = .002 ) . Similarly , overall survival continued to be worse with transfusion for stage IA ( P < .001 ) and IB ( P < .001 ) . For disease-free and overall survival , univariate analysis revealed increased age , male gender , anemia , transfusion , and higher stage to be adverse factors , with transfusion and higher stage continuing to be significant adverse factors after multivariate analysis . CONCLUSIONS Our data suggest that transfusion of LD blood is associated with a worse disease-free and overall survival in patients with resected stage I non-small cell lung cancer BACKGROUND Anemia is common in myeloproliferative neoplasm (MPN)-associated myelofibrosis . The Functional Assessment of Cancer Therapy ( FACT ) measurement system is a patient-reported outcomes instrument that documents symptoms of the diverse aspects of cancer treatment . One FACT version , FACT-Anemia ( FACT-An ) , documents symptoms of anemia related to cancer . The FACT-An has been vali date d in diverse cancer population s , but not in MPN-associated myelofibrosis . OBJECTIVE Our aim was to evaluate the relationship between anemia response to therapy with pomalidomide with or without corticosteroids and patient-reported outcomes using the FACT-An instrument . METHODS Data were obtained from a Phase II , r and omized , double-blind Bayesian pick-the-winner trial of prednisone and pomalidomide in patients with MPN-associated myelofibrosis and anemia ( red blood cell-transfusion dependence ) . Details of the study , including definitions of anemia , anemia response , red blood cell-transfusion , red blood cell-transfusion dependence , and red blood cell-transfusion independence , are reported . Change in quality of life from r and omization to the last cycle of therapy was evaluated using the FACT-An Physical Well Being , Functional Well Being , Trial Outcome Index , and Anemia domains . Clinical ly important differences were used to determine the smallest difference in scores that patients perceived as beneficial in the FACT-An domains of interest . Patients were classified as meeting clinical ly important differences for responsiveness if their change score from baseline was > 1 SEM , indicating improvement . RESULTS Eighty-five patients were studied . Thirty-one patients ( 37 % ) were classified as anemia responders by prospect ively defined criteria . Across all FACT-An domains , anemia responders showed greater improvement in Physical Well Being , Functional Well Being , and Trial Outcome Index scores than did nonresponders . This improvement began at the second 28-day cycle of therapy and was sustained . CONCLUSIONS We show a correlation between anemia response and improved quality of life measured by the FACT-An instrument in patients with MPN-associated myelofibrosis and anemia Background : The aim of the present study was to investigate any prognostic value of pre-treatment anemia , leukocytosis and thrombocytosis in patients with advanced pretreated NSCLC . Methods : A r and omized , multicenter phase II study comparing the IGF-1R modulator AXL with st and ard docetaxel in the treatment of previously treated stage IIIB or IV NSCLC patients was conducted in 2011 - 2013 . Clinical and laboratory data were collected , including serum values for hemoglobin ( Hgb ) , white blood cells ( WBC ) and platelets ( Plt ) at baseline . These hematological parameters were studied in relation to overall survival using Kaplan – Meier product-limit estimates and multivariate Cox proportional hazards regression models . Results : The median overall survival for all patients was 8.9 months . Patients with  leukocytosis  ( WBC > 9 x 109/L ) had a significantly shorter median overall survival ( 4.2 months ) as compared with those with a WBC ≤ 9 x 109/L at baseline ( 12.3 months ) with a corresponding of HR 2.10 ( 95 % CI : 1.29 - 3.43 ) . Patients with anemia ( Hgb < 110 g/L ) had a non-significant ( p = 0.097 ) shorter median overall survival ( 6.1 months ) as compared with their counterparts with Hgb ≥ 110 g/L at baseline ( 9.4 months ) . As for thrombocytosis ( Plt > 350 x 109/L ) , there was no statistically significant impact on overall survival . Leukocytosis retained its prognostic significance in a multivariate model where other clinical factors such as age , sex and WHO performance status were taken into consideration ( HR : 1.83 , 95 % CI : 1.06 - 3.13 , p = 0.029 ) . Conclusion : Pre-treatment leukocytosis is a strong and independent prognostic marker for shorter overall survival in previously treated stage IIIB or IV NSCLC patients receiving docetaxel or AXL1717 . Combined use of pre-treatment leukocytosis assessment s together with established prognostic factors such as performance status could be of help when making treatment decisions in this clinical setting It has been postulated that transfusions have immunosuppressive effects that promote tumor growth and metastasis . Moreover perioperative anemia is considered an independent prognostic factor on outcome in patients operated for malignancy . We evaluated the influence of red blood cell ( RBC ) transfusions and perioperative anemia on survival in non-small cell lung carcinoma ( NSCLC ) patients . From 1999 through 2005 , 331 consecutive patients , male/female=295/36 ( mean age 64+/-9 years ) , who underwent radical surgery for NSCLC were prospect ively enrolled in this cohort and followed up for a mean of 27.2 months . The overall survival of patients was analyzed in relation to RBC transfusions and perioperative anemia . These parameters were analyzed in the whole cohort of patients and separately for stage I patients . Patients were divided according to perioperative transfusion , into Group A ( transfused ) and Group B ( non-transfused ) and according to the preoperative haemoglobin ( Hb ) level into Group 1(Hb<12g/dl ) and Group 2(Hb > or = 12g/dl ) , respectively . The overall transfusion rate was 25.7 % . Univariate analysis showed that in the whole cohort of patients overall survival was significantly shorter in Group A ( mean 33.6 months , 5-year survival 25.1 % ) compared to Group B ( mean 48.0 months , 5-year survival 37.3 % ) ( p=0.001 ) . It also showed that patients with preoperative Hb level < 12g/dl ( Group 1 ) , ( mean of 33.0 months , 5-year survival 21.3 % ) had shorter survival compared to Group 2 patients ( mean 49.3 months and 5-year survival 40.0 % ) , respectively ( p=0.002 ) . Multivariate analysis in the whole cohort of patients showed that preoperative anemia was an independent risk factor for survival while RBC transfusion was not . In particular for stage I patients , it was shown that  RBC transfusion  was an independent prognostic factor for long-term survival as detected by multivariate analysis ( p=0.043 ) , while anemia was not . RBC transfusions affect adversely the survival of stage I NSCLC patients , while do not exert any effect on survival of patients with surgically resectable more advanced disease , where preoperative anemia is an independent negative prognostic factor . These findings indicate that RBC transfusion might exert an immunomodulatory effect on patients with early disease while in more advanced stages this effect is not apparent The objective of this retrospective study was to investigate prognostic factors associated with survival of patients with extensive stage small cell lung cancer ( ES-SCLC ) . Included were 200 patients admitted to the Liberation Army General Hospital with a diagnosis of ES-SCLC . The demographics of patients , disease characteristics , pre-treatment biochemical parameters and therapeutic plan were assessed or evaluated . Univariate analysis found that second-line chemotherapy , radiotherapy , and no liver metastasis were associated with improved survival . Tumor response to first-line chemotherapy and normal initial hemoglobin levels were also associated with a survival benefit ( all P-values ≤ 0.0369 ) . Multivariate Cox regression analysis indicated that liver metastasis and the total number of all chemotherapy cycles were independent prognostic factors of survival . The morbidity risk in patients with liver metastasis was 2.52-fold higher than that in patients without liver metastasis ( hazard ratio (HR)=2.52 ( 1.69 - 3.76 ) ; P<0.0001 ) . However , one unit increase in the total number of chemotherapy cycles decreased the risk of death by 0.86-fold ( HR=0.86 ( 0.80 - 0.92 ) ; P<0.0001 ) . Absence of liver metastasis and ability of a patient to receive and tolerate multiple lines of chemotherapy were associated with longer survival BACKGROUND Cisplatin-induced anemia may correlate with adverse events , poor quality of life ( QoL ) , decreased adjuvant chemotherapy ( ACT ) dose intensity , shorter relapse-free survival ( RFS ) or overall survival ( OS ) . METHODS The JBR.10 trial demonstrated significantly longer survival with adjuvant cisplatin and vinorelbine  ( n=242 ) compared to observation  ( n=240 ) in patients with resected NSCLC [ Winton T , Livingston R , Johnson D , Rigas J , Johnston M , Butts C , et al. Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer . N Engl J Med 2005;352(25):2640 - 2 ] . This exploratory analysis evaluates the predictive value of baseline ( in all patients ) and during-treatment ( in ACT arm only ) hemoglobin ( Hb ) levels on OS and RFS when adjusted for prognostic factors . Baseline ( in all patients ) and during treatment ( in ACT arm only ) Hb levels were also correlated with adverse events , QoL , morbidity and ACT dose intensity . RESULTS Baseline Hb did not predict RFS or OS . However , there was a trend to shorter OS ( p=0.1 ) when baseline Hb was < 120g/L. Lower baseline Hb predicted increased hospitalization ( p=0.04 ) and worse QoL ( SOB item , p=0.03 ) but had no impact on adverse events or dose intensity . There was a trend to longer RFS ( p=0.08 ) in patients with lower nadir during-treatment Hb and to longer OS ( p=0.06 ) and RFS ( p=0.08 ) in patients with maximum during-treatment Hb drop > 30 % that was not maintained when ACT dose intensity was included in the model . Maximum during-treatment Hb drop > 30 % correlated with increased lethargy ( p=0.003 ) and worse QoL ( fatigue item , p=0.07 ) . CONCLUSIONS Lower baseline and during-treatment Hb levels seem associated with poorer QoL , fat 
    Output:
    
Funnel plot and statistical analyses showed no evidence of publication bias .
The results of meta-regression analysis suggested no evidence of significant heterogeneity between subgroups .
In conclusion  , pre-operative anemia was associated with poorer overall survival among LC patients