What are the American Society of Hematology (ASH) and ASCO recommendations for use of erythropoiesis-stimulating agents (ESAs) in multiple myeloma (MM)?

Updated: Jul 15, 2019
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

A joint American Society of Hematology (ASH) and ASCO clinical practice guideline on the use of erythropoiesis-stimulating agents (ESAs) in cancer was updated in 2010. The specific recommendations for patients with multiple myeloma receiving concurrent chemotherapy include the following [127] :

  • If the hemoglobin concentration does not increase after chemotherapy, treatment with epoetin or darbepoetin may be considered in patients who are being treated with palliative intent and who are experiencing chemotherapy-associated anemia
  • Particular caution should be exercised in the use of epoetin or darbepoetin concomitant with chemotherapeutic agents where risk of thromboembolic complications is increased
  • Blood transfusion is also a therapeutic option
  • ESAs are not recommended in patients who are not receiving concurrent chemotherapy

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