Guidelines for Epo use in children with cancer

Supportive Care in Pediatric Oncology

“…With the paucity of reported data, similar such guidelines are unavailable in the pediatric literature. In his editorial response to the French guidelines, Feusner ( 2009 ) concurs that evidence is lacking to support ESA use in pediatric oncology patients as their benefi t in quality of life and cost-effectiveness in this patient population as well as their potential risks in regard to tumor progression, overall survival and thromboembolism are unclear. From the adult oncology literature it is unclear if there is potency difference between subcutaneous and intravenous rhEPO administration although studies in adult hemodialysis patients have shown that subcutaneous injection is approximately 30 % more effective (Kaufman et al 1998 ;Galliford et al 2005 ;Vercaigne et al 2005 ).…”