Does treatment with recombinant human erythropoietin affect the survival of anemic patients with cancer?

David P Steensma* and Thomas E Witzig

This article has no abstract so we have provided the first paragraph of the full text.

Cancer-associated anemia is one of the most common complications of neoplastic disease and its therapy, and is simple to diagnose and relatively easy to treat. Red blood cell transfusions reliably raise hemoglobin levels and improve tissue oxygen delivery, and can ameliorate many symptoms experienced by anemic patients. While the blood supply in the developed world is currently very safe, some risks remain, and the donor pool is limited. Fortunately, multiple randomized trials have demonstrated that treatment with recombinant human erythropoietin can increase hemoglobin levels and spare some patients from potentially dangerous and inconvenient transfusions. The recent meta-analysis by Bohlius et al. quantifies these benefits (e.g. about six severely anemic patients need to be treated with erythropoietin to rescue one patient from transfusions) and provides an initial assessment of whether this class of drugs might potentially improve efficacy of cancer therapy and, consequently, life expectancy. The analysis does not address quality-of-life changes with erythropoietin, an area of some controversy at present.

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