Management of chemotherapy-induced anemia

Chronic anemia associated with cancer often causes poor quality of life and is often exacerbated by intensive treatment. In recent controlled trials, recombinant human erythropoietin (rhEpo) proved to be well tolerated and effective in amelioration and reduction of transfusion requirements of cancer-associated anemia. Double-blind placebo-controlled trials of rhEpo in patients undergoing allogenic, but not autologous, bone marrow transplantation showed significant acceleration of the reconstitution of erythropoiesis. Multivariate analysis revealed that serum erythropoietin levels of 100 mU/mL or greater and an increase in hemoglobin by at least 0.5 g/dL was a probable response; conversely, a serum ferritin level of 400 ng/mL or greater after 2 weeks indicated a poor response to rhEpo therapy. Further studies are needed to define patient populations in whom cost-effective rhEpo therapy is justified.