Editor’s Note: Chronic disease-related anemia, as one of the most common types of anemia, is the most common type of anemia among hospitalized patients and elderly individuals. Chronic disease-related anemia is usually accompanied by underlying diseases, with complex causes and diverse symptoms, distributed across multiple departments. Clinical doctors should pay sufficient attention to it in order to achieve better treatment outcomes. At the recent 19th National Conference on Red Blood Cell Diseases (Anemia) hosted by the Chinese Medical Association, Professor Zhongxing Jiang from The First Affiliated Hospital of Zhengzhou University shared the progress and prospects of the diagnosis and treatment of chronic disease-related anemia with Oncology Frontier – Hematology Frontier.
Oncology Frontier – Hematology Frontier: Etiological treatment is the cornerstone of the treatment of chronic disease-related anemia. Could you please introduce the main causes of chronic disease-related anemia?
Professor Zhongxing Jiang: It was previously believed that the main cause of chronic disease-related anemia was immune system-related factors such as chronic inflammation and malignant tumors. However, with further research, the current understanding of the causes has expanded. Not only does it include anemia caused by chronic obstructive pulmonary disease (COPD), diabetes, heart failure, obesity, and other factors, but it also encompasses unexplained anemia in the elderly and anemia in critically ill patients in ICU wards. These are all among the causes of chronic disease-related anemia.
Oncology Frontier – Hematology Frontier: With the aging population in China, what aspects should be considered in the treatment of chronic disease-related anemia in elderly individuals?
Professor Zhongxing Jiang: The treatment of anemia in elderly individuals needs to be individualized and tailored to each patient. Because some elderly patients may have concomitant chronic diseases such as COPD, heart failure, diabetes, or even unexplained causes. Therefore, when elderly patients develop anemia, screening and examinations are necessary. If findings such as increased cytokines, elevated ferritin, or disturbances in iron metabolism are observed, the patient’s anemia is likely chronic disease-related. For such patients, treatment should focus on using drugs with minimal side effects. For example, in the treatment of anemia in diabetic patients, drugs that do not increase the risk of abnormal blood sugar levels should be chosen, while in patients with heart failure, factors contributing to heart failure should be minimized. By selecting drugs that patients tolerate well, the aim is to improve anemia symptoms and minimize the need for blood transfusions in elderly patients.
Oncology Frontier – Hematology Frontier: You have been deeply involved in the field of anemia for many years and have made significant progress. What do you think are the new trends in the diagnosis and treatment of chronic disease-related anemia in the future?
Professor Zhongxing Jiang: In terms of diagnostic criteria, the past relied on medical history, hemoglobin levels, and changes in iron metabolism. However, some new indicators have emerged (such as increased ferritin and cytokines), although they have not yet been included in guidelines. With the development and advancement of diagnostic techniques, these new methods may also become new diagnostic criteria for chronic disease-related anemia.
In terms of treatment, significant progress has also been made. Traditional treatments mainly relied on blood transfusions, iron supplementation, and erythropoiesis-stimulating agents, but they did not effectively address the underlying causes of chronic disease-related anemia. With the advancement of diagnostic and treatment technologies, new types of therapeutic drugs have emerged, particularly those targeting the mechanisms of increased ferritin. These include drugs such as heparin derivatives and antibody drugs (such as interleukin-6 receptor antagonists), which can effectively reduce ferritin levels and improve anemia in patients, benefiting more individuals.
Expert Profile
Professor Zhongxing Jiang
- Second-level professor, chief physician, doctoral supervisor, postdoctoral mentor, renowned physician in the Central Plains region
- Head of the Hematology Department at the First Affiliated Hospital of Zhengzhou University
- Member of the Chinese Medical Association Hematology Branch, Deputy Leader of the Red Blood Cell Group
- Director of the Hematology Society of the Henan Medical Association, Head of the Red Blood Cell Group
- Member of the Chinese Medical Doctor Association Hematology Branch
- Standing Committee Member of the Chinese Anti-Cancer Association Blood Tumor Professional Committee
- Standing Committee Member of the China Hospital Association Hematology Institute
- Member of the CSCO China Anti-Leukemia Alliance
- Deputy Head of the Red Blood Cell Group of the Hematology Branch of the Beijing Cancer Association
- Head of the Henan Experimental Hematology Society
- Head of the Hematological Disease Translational Medicine Committee of the Henan Anti-Cancer Association
