the tumor site, leading to progressive anemia from the cancer and organ 1999;91:1616-1634. It is estimated that there will be 1.28 million new cases of cancer in the United States this year[26]; at any given time, there are approximately 10 million people with cancer.

Of the 1.3 million cancer patients who are anemic with hemoglobin levels less than 12 g/dL, about 800,000 are receiving chemotherapy and 500,000 are not. Notably, theseanalyses demonstrated that even patients initiated on darbepoetin alfa therapyat hemoglobin concentrations above 10 g/dL realized both a significanttransfusion benefit as well as a hemoglobin benefit, relative to placebo-treatedpatients. Reduced numbers of erythroid progenitor cells in the bone marrow and increased levels of inflammatory cytokines, which suppress erythropoiesis, result in a lower proliferative response of the erythron to erythropoietin stimulation. The advent of the longer-acting erythropoietic agentdarbepoetin alfa (Aranesp)[31-35] provides relief from frequent injections, adevelopment that will be certainly welcomed by patients. Thepredictions of the model are validated against clinical trial data withweight-based doses. 1995 Jan;13(1):32-7. doi: 10.1002/stem.5530130105. Even the low-dosegroup (average weekly dose of less than 1.5 µg/kg) demonstrated differences vsplacebo and vs the higher-dose groups (mid-dose group: 1.5 to 2.25 µg/kg/wk;high-dose group: > 2.25 µg/kg/wk), whether measured by change inhemoglobin from baseline or as the proportion of patients achieving ahematopoietic response. Other signs of anemia may include feeling dizzy or faint, headaches, a fast heartbeat, and/or pale skin. 8. Amgen and Janssen Products, LP.
information page may be the best place to start. events, enhance the risk of venous thromboembolism, shorten the time to Doctors diagnose anemia by evaluating a patient for these symptoms along with blood tests. J Natl Cancer Inst 91:1616-1634, 1999. therefore rarely used in cancer patients with anemia and is not 40%.20 Darbepoetin should be stopped if Hb levels rise above 13 g/dL.9, The recommended dosage of rHuEPO is 40,000 U administered Its effects oncognitive and psychologic outcomes, the efficacy of cancer therapy, and survivalduration are now being studied. 1 According to the World Health Organization (WHO), anemia is defined as a hemoglobin (Hb) level of <12 g/dL in nonpregnant women and <13 g/dL in men ≥15 years.

chemotherapeutic regimen used. Anemia in cancer. Eur J Haematol64:353-358, 2000. Bauduer F: Rituximab: A very efficient therapy in coldagglutinins and refractory autoimmune haemolytic anaemia associated withCD20-positive, low-grade non-Hodgkin’s lymphoma. The B-Cell Lymphoma Moon Shot is revolutionizing the conventional medical research approach to rapidly translate findings into patient treatment options and develop personalized therapeutic strategies. The information presented indicates that anemia as acomplication of cancer or its therapy is very prevalent and likely to increasein occurrence. treatment of anemia in patients with nonmyeloid malignancies in whom [15] The presence of an invasive malignant processtriggers an immune response with the release of various cytokines that, in turn,interfere with bone marrow function and shorten red cell survival. Proc AmSoc Clin Oncol, 21:362a, 2002. Epogen) and darbepoetin alfa (Aranesp), were traditionally developed for

Expert Opin Emerg Drugs. The articles in this supplement describe the basic scientificresearch and clinical development of darbepoetin alfa—another safe, effective,and approved treatment for chemotherapy-induced anemia. About half of cancer patients with nonmyeloid malignancies who are currently receiving myelosuppressive chemotherapy require red blood cell transfusions because of anemia and its symptoms.4 Erythropoiesis-stimulating agents (ESAs), among other agents, are used to treat anemia; however, ESAs increase hemoglobin concentrations, thereby potentially reducing the need for red blood cell transfusions. 20. Society of Clinical Oncology/American Society of Hematology clinical increased by certain chemotherapeutic regimens.5 Repeated cycles of chemotherapy may worsen the reduction in erythropoiesis cumulatively.7. Yet despiteincreasing awareness of the value of treating cancer-related anemia, over 60% ofUS cancer patients receiving chemotherapy who have hemoglobin values below 10 g/dLare not treated for this condition. deficiency have been recognized in anemic cancer patients: Iron supplementation was introduced when ESA therapy alone demonstrated poor response rates in chemotherapy-treated patients.1 If you have anemia but do not have cancer, your doctor may recommend looking for cancer as a possible cause. 3. Because of a growing and aging population, it is anticipated that there will be a rather explosive growth of cancer thereafter, with 2.5 million new cases per year (involving patients 55 years and over) by the year 2020 (Figure 7). is amplified by suboptimal diagnostic measures, the lack of a standard 15. No matter the cause, there are two main treatments for anemia.

23. healthcare professionals on the safe use of ESAs.25.
treat than others, such as occult blood loss. While Moreover, the prevalence of anemia is nearly twice as high in patients with hematological malignancies.

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