title: Erythropoiesis-stimulating agents in cancer patients: reflections on safety.
abstract: Chemotherapy-induced anemia (CIA) is a frequent problem in cancer patients with a negative impact on prognosis and quality of life. Erythropoiesis-stimulating agents (ESAs) have proven efficacy in improving hemoglobin levels and reducing red blood cell transfusion needs of these patients. In several randomized studies in settings other than CIA (such as patients not receiving any chemotherapy, or studies on preventive use of ESAs to keep high hemoglobin levels), safety signals that ESA therapy may result in worse cancer outcome were documented. We review the evidence for these safety concerns, the different hypotheses to explain effects on outcome, the implications of the more restrictive guidelines on ESA therapy on daily practice and possible alternative treatments to consider.
authors: Respiratory Oncology Unit (Pulmonology) and Leuven Lung Cancer Group, University Hospital Gasthuisberg, Catholic University, Leuven, Belgium.
authors: Isabelle
authors: I
authors: Wauters
authors: Johan
authors: J
authors: Vansteenkiste
mesh_terms: D000740:Anemia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000097:blood; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics