Anemia in Cancer Patients

Anemia in Cancer Patients is a topic covered in the Washington Manual of Medical Therapeutics.

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Although ESA therapy has been shown to reduce transfusion requirements in chemotherapy-related anemia, their use remains controversial because of evidence of increased mortality risk in cancer patients.1 They confer an elevated risk of thrombosis regardless of baseline Hgb level. Current guidelines recommend ESA therapy should only be considered in transfusion-dependent cancer patients with Hgb level <10 g/dL who are receiving myelosuppressive chemotherapy without a curative intent, except in the case of patients with lower risk MDS. The goal of ESA therapy is to achieve the lowest Hgb concentration needed to reduce transfusion requirement. Iron replacement therapy can be used in conjunction to improve Hgb response in patients receiving ESA with or without iron deficiency.

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Although ESA therapy has been shown to reduce transfusion requirements in chemotherapy-related anemia, their use remains controversial because of evidence of increased mortality risk in cancer patients.1 They confer an elevated risk of thrombosis regardless of baseline Hgb level. Current guidelines recommend ESA therapy should only be considered in transfusion-dependent cancer patients with Hgb level <10 g/dL who are receiving myelosuppressive chemotherapy without a curative intent, except in the case of patients with lower risk MDS. The goal of ESA therapy is to achieve the lowest Hgb concentration needed to reduce transfusion requirement. Iron replacement therapy can be used in conjunction to improve Hgb response in patients receiving ESA with or without iron deficiency.

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