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According to a study published in The Oncologist, cancer patients with mild-to-moderate anemia have worse quality of life than the general population. However, treatment of anemia improved quality of life, particularly among those who received treatment when anemia was still mild.

Anemia is a common adverse effect of some chemotherapy regimens. It is characterized by low levels of circulating red blood cells, which are responsible for delivering oxygen to tissues throughout the body.

Common symptoms of anemia are severe fatigue, shortness of breath, diminished activity levels, and a reduced overall feeling of well-being.

Severe anemia often requires treatment with blood transfusions, which have associated risks of infection, rejection, and increased medical costs. Furthermore, severe anemia may cause a delay in cancer treatment, resulting in suboptimal chances of a cure or optimal long-term survival.

Treatment of anemia with medications that stimulate the production of red blood cells (erythropoietic treatment) has been shown to have several benefits in cancer patients, including increased quality of life and decreased need for blood transfusions. These medications include Aranesp® (darbepoetin alfa) and Procrit® (epoetin alfa).

An issue that has remained controversial, however, is whether mild anemia (defined as a hemoglobin level between 10 g/dL and 12 g/dL) should be treated with these medications, or whether treatment should be deferred until anemia becomes more severe.

A clinical trial conducted in the Netherlands evaluated treatment with epoetin-alfa among cancer patients receiving platinum-based chemotherapy. Patients had hemoglobin levels of 12.1 g/dl or lower at the start of the study.

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Previously published results from this study indicated that patients treated with epoetin-alfa were less likely to receive a blood transfusion and reported better quality of life. In the current analysis, the quality of life of study subjects was compared to a measure of quality of life in the general population.

Results showed an improvement in quality of life when anemia was treated at a mild stage:

  • At the start of the study, study subjects had worse quality of life than the general population.
  • Among patients assigned to receive treatment with epoetin-alfa, quality of life improved significantly over the course of the study.
  • Improvements in quality of life were especially large for patients who received epoetin-alfa when anemia was still mild (more than 10.5 g/dl).

The researchers conclude that “these data suggest that early treatment with epoetin alfa to correct anemia can improve [quality of life] in a clinically significant and meaningful way.”

Reference: Savonije JH, van Groeningen CJ, Wormhoudt LW et al. Early Intervention with Epoetin Alfa During Platinum-Based Chemotherapy: An Analysis of Quality-of-Life Results of a Multicenter, Randomizd, Controlled Trial Compared with Population Normative Data. The Oncologist. 2006;11:197-205.

Related News:Treatment of Mild Anemia Reduces Need for Blood Transfusions (1/31/06)

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