The relationship between anemia and quality of life in cancer patients

Anemia is a common occurrence in patients with cancer, and especially in those who undergo chemotherapy. Traditionally, significantly decreased hemoglobin levels have been considered to be < or = 8 g/dl and have been associated with physiologic manifestations. More recent data have shown that milder anemia (hemoglobin levels 10-12 g/dl) has functional consequences as well. This article reviews several community-based studies that have analyzed changes in hemoglobin concentrations, transfusion requirements, and QOL parameters in anemic patients with cancer before and after treatment with epoetin alfa. The results of these studies have been consistent and show an increase in hemoglobin and a reduction in transfusion requirements when compared with baseline. Furthermore, a relationship between increasing hemoglobin levels and an improvement in QOL is suggested that is independent of tumor response. Additional studies are evaluating the optimal hemoglobin levels for the greatest incremental improvement in QOL.