Anemia, fatigue and aging.
Aging is associated with increased incidence and prevalence of both cancer and anemia. Cancer and aging may conspire in making anemia more frequent and more severe. This article reviews the causes and the consequences of anemia in the older individual. The most common causes include chronic inflammation that is a typical manifestation of aging, iron deficiency that may be due to chronic hemorrhage, malabsorption and Helicobacter pylori infection, cobalamin deficiency from malabsorption and renal insufficiency. Other causes of anemia whose prevalence is not well established include myelodysplasia, copper deficiency, hypothyroidism, and sarcopenia. Anemia is associated with increased risk of mortality, functional dependence, dementia, falls, and chemotherapy-related toxicity. When correcting the anemia of older cancer patients one should remember that the erythropoietic stimulating agents (ESA) may stimulate cancer growth and cause thrombosis. These products may be safe when given exclusively to patients receiving chemotherapy and when the hemoglobin levels are maintained below 12 g/dL.
H Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr, Tampa, FL 33612, USA. balducci@moffitt.usf.edu
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D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000740:Anemia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D003072:Cognition Disorders / Q000209:etiology; D003131:Combined Modality Therapy; D015897:Comorbidity; D000075202:Contraindications; D005221:Fatigue; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006333:Heart Failure / Q000097:blood / Q000150:complications; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000453:epidemiology; D008286:Malabsorption Syndromes / Q000150:complications; D008297:Male; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D020246:Venous Thrombosis / Q000139:chemically induced
D000970:Antineoplastic Agents; D006397:Hematinics; D006454:Hemoglobins