2007 Standards, Options, and Recommendations: use of erythropoiesis-stimulating agents (ESA: epoetin alfa, epoetin beta, and darbepoetin) for the management of anemia in children with cancer.
The Standards, Options, and Recommendations (SOR) project undertaken by the French National Federation of Cancer Centers (FNCLCC) to develop and disseminate clinical practice guidelines in oncology has now been taken over by the French National Cancer Institute. In 2007, the SOR updated the information related to the use of erythropoiesis-stimulating agents (ESA) in anemic children with cancer. Updates were based on a review of the most reliable scientific data available, followed by critical appraisal by a multidisciplinary group of experts and validation by independent experts. The literature review identified four randomized trials likely to provide reliable new information on the use of ESA in children. This review confirmed four points: treatment increases hemoglobin levels and decreases the need for blood transfusions; no quality-of-life and no survival benefit has been demonstrated; treatment does not seem associated with significantly more side effects; impact on thromboembolic events and patient quality of life remains unclear. The main result of the study was the elaboration of a new standard of care unavailable at the time of the 2003 version. Systematic administration of ESA is not recommended for the prevention or treatment of anemia in pediatric cancer patients. However, treatment decision must be made on a case-by-case basis and, when treatment is considered, the intravenous route must be preferred. The full French document is available at www.sor-cancer.fr.
Marec-Berard
Perrine
P
Department of Pediatrics, Hemato-Oncologic Pediatric Institute, Lyon, France. marec@lyon.fnclcc.fr
Chastagner
Pascal
P
Kassab-Chahmi
Diana
D
Casadevall
Nicole
N
Marchal
Christian
C
Misset
Jean-Louis
JL
Ray-Coquard
Isabelle
I
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D000818:Animals; D049109:Cell Proliferation / Q000187:drug effects; D002648:Child; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D009369:Neoplasms / Q000150:complications* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D017467:Receptors, Erythropoietin / Q000378:metabolism; D011994:Recombinant Proteins; D015996:Survival Rate
D006397:Hematinics; D017467:Receptors, Erythropoietin; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa