Management of anemia in patients with cancer.
Anemia is extremely common in patients with cancer. Low hemoglobin levels are associated with diminished quality of life and possibly decreased overall survival. Successful treatment of anemia has undeniable benefits for patients, often yielding dramatic symptomatic improvement that can be very satisfying for clinicians to observe. This review focuses on evolving issues in the management of anemia in patients suffering from cancer. Topics addressed include new evidence-based guidelines concerning the use of epoetin alfa, the evolving role of darbepoetin alfa in cancer-associated anemia, the potential for concomitant iron supplementation to maximize response to erythropoietic agents, the unresolved question of whether erythropoietin use affects survival in cancer patients, new concerns about the risk of thromboembolism in cancer patients with higher hemoglobin levels who are receiving epoetin, and possible immunosuppressive effects of blood product transfusions that may have relevance to neoplasia progression.
Steensma
David P
DP
Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. steensma.david@mayo.edu
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D000068256:Darbepoetin alfa; D004359:Drug Therapy, Combination; D000068817:Epoetin Alfa; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011994:Recombinant Proteins; D013923:Thromboembolism / Q000209:etiology; D016896:Treatment Outcome
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa; D007501:Iron