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Anemia in Patients With Cancer or Undergoing Cancer Therapy: Impact and Current Treatment Practice

David H. Henry, MD
Joan Karnell Cancer Center
Pennsylvania Hospital
Philadelphia, Pennsylvania, USA

Summary
Anemia is a multifactorial and global problem in cancer patients and negatively impacts quality of life (QOL) and treatment outcomes. This article provides an update on several aspects of anemia, including its etiology, prevalence, and broad impact; goals of anemia treatment; available treatment options; published treatment guidelines; and future areas of investigation, with the aim of providing information to guide optimal anemia management in cancer patients. Based on clinical practice and trial data over the last decade, treatment with epoetin alfa 150-300 U/kg three times weekly or 40,000-60,000 U once weekly (QW) results in mean hemoglobin (Hb) increases of ~1 g/dL after 4 weeks and ~2 g/dL after 8 weeks that are associated with significant reductions in transfusion requirements and QOL improvements in anemic cancer patients. Darbepoetin alfa 2.25-4.5 μg/kg QW or 3.0-5.0 μg/kg every 2 weeks results in mean Hb increases of ~1.5 g/dL by end of treatment and significantly reduces transfusion requirements; QOL endpoints are promising. Ultimately, anemia treatment should be guided by experience and anemia treatment guidelines, such as those provided by the National Comprehensive Cancer Network (NCCN) and the American Society of Hematology/American Society of Clinical Oncology (ASH/ASCO).

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