Management of Anemia in Cancer Patients

Aknar Calabrich; Artur Katz

Disclosures

Future Oncol. 2011;7(4):507-517. 

In This Article

Abstract and Introduction

Abstract

Cancer-related anemia adversely affects quality of life and is associated with reduced overall survival. The correction of anemia in cancer patients has the potential to improve treatment efficacy and increase survival. A large number of studies demonstrate that treatment of anemia in cancer patients using erythropoiesis-stimulating agents (ESAs) significantly increases hemoglobin levels, decreases transfusion requirements and improves quality of life, predominantly by reducing fatigue. Some data on the use of ESAs in cancer patients indicate an increased risk of thromboembolic events and a possibly increased risk of mortality. However, there is ample evidence that when ESAs are used within current guidelines, they are valuable and safe drugs for the treatment of anemia in patients receiving radiotherapy and/or chemotherapy. There are increasing data from prospective, randomized trials demonstrating better responses to ESAs with the concurrent use of iron. Blood transfusions are also helpful in the management of anemia in cancer patients, especially when there is a need for immediate increases in hemoglobin levels. In this article, we discuss recent aspects relating to treatment modalities for anemia in cancer patients.

Introduction

Anemia is the most frequent hematological manifestation in patients with cancer. Typically, anemia in such patients is multifactorial, resulting directly from the myelosuppressive effect of chemotherapy and from complications related to the underlying disease.[1] According to the WHO[2] and the National Cancer Institute,[101] anemia is categorized into four categories according to the level of hemoglobin (Table 1). Anemia results in a series of symptoms that can influence the physical and functional status of patients, negatively affecting their treatment and quality of life (QOL). Symptoms of anemia include palpitations, fatigue, dyspnea, nausea, depression, heart failure, impairment of cognitive function and dizziness.[3] The duration and severity of anemia seems to be related to the type of cancer, extent of disease and myelosuppressive potency of chemotherapy. In this article, we will discuss the more recent aspects relating to treatment modalities for anemia in cancer patients.

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