Safety considerations for erythropoietin treatment in patients with cancer

Abstract

Cancer-related anaemia, which affects many patients with cancer, can effectively be treated by erythropoietic proteins. Erythropoietic proteins increase haemoglobin levels, reduce the risk for transfusions and also improve the quality of life of patients. When used according to published practice guidelines, these proteins benefit many patients and are generally well tolerated. Important side effects are hypertension and thromboembolic events, either of which occurs in < 10% of the patients. Administration only in anaemic patients, avoidance of target haemoglobin levels > 130 g/l, proper dose adjustments and close monitoring during treatment will ensure the clinical safety of these proteins. However, the association between erythropoietic proteins and outcome of anticancer therapy, including survival, requires further study.

The Role Of Erythropoietin In The Treatment Of Anemia In Patients With Malignant Lymphoma

“…Malignant lymphomas promote infl ammatory cytokine production, which suppresses erythropoesis and erythropoetin production [13]. Data from many studies indicate that treatment of anemic patients with erythropoesis stimulating agents improves erythropoiesis, increases the hemoglobin concentration, decreases the need of transfusion, and also improves their quality of life [8,14,15,16]. Th e obtained results show that the diff erence between mean hemoglobin level after four weeks after onset of therapy was extremely signifi cant (p <0.0001), and hemoglobin levels at week four ranged from 8.81 g/dl (SD 1.044) to 9.74 g/dl (SD 1.090).…”

Spanish Society of Medical Oncology consensus on the use of erythropoietic stimulating agents in anaemic cancer patients

“…In patients with either untreated hypertension or with poorly controlled hypertension, it may be necessary to modify the antihypertensive treatment. If the hypertension remains uncontrollable, treatment with epoetin should be discontinued [67]. In some of the RCT in which an increased risk was found, excessive levels of Hb were reached, higher than the levels usually reached in community practice.…”