Recombinant human erythropoietin treatment of anemic cancer patients.

PURPOSE

This article describes the mechanism of anemia in patients with cancer and the potential role of recombinant human erythropoietin in its treatment. Dosing, safety, prediction of response, and reimbursement issues also are discussed.

OVERVIEW

Patients with advanced cancer frequently experience significant, chronic anemia that can contribute to overall morbidity. The causes of this anemia are multifactorial, including blood loss, nutritional deficiencies, hemolysis, bone marrow infiltration by tumors, and the anemia of chronic disease. In addition, myelosuppressive chemotherapy can cause or exacerbate this anemia.

CLINICAL IMPLICATIONS

Several clinical studies have demonstrated that the use of recombinant human erythropoietin may prevent or ameliorate anemia by significantly increasing the hematocrit in patients who receive chemotherapy. This can reduce the proportion of patients who require erythrocyte transfusions. In addition, responding patients experience an improvement in quality of life.