The NCCN Cancer and Treatment-Related Anemia Guidelines were developed to assist clinicians in making decisions about when and how to treat cancer and treatment-related anemia. In particular, these guidelines focus on the type of anemia associated with chronic disease and review the available data guiding the use of erythropoietin in these patients. said Paul Sabbatini, MD, Assistant Attending Physician in the Developmental Chemotherapy Service at Memorial Sloan-Kettering Cancer Center and chairman of the NCCN Anemia Guidelines Panel.

Anemia may be caused by a variety of factors. In cancer patients, it often occurs in the setting of normal serum iron levels and is associated with inappropriately low serum erythropoietin production. Symptoms of anemia in patients range from shortness of breath, rapid heartbeat, and dizziness to inability to concentrate, weakness and fatigue. Available data support the concept that fatigue in patients with cancer is a multifactorial entity, and anemia represents a treatable subset of a very complex problem. Prior to the development of erythropoietin, the only way to treat patients with cancer and treatment-related anemia was with transfusion. The availability of erythropoietin provides a transfusion alternative in certain settings, and provides the ability to maintain hemoglobin in the normal range.

The NCCN guidelines recommend that patients with hemoglobin levels of < 11 g/dl enter the screening portion of the algorithm. If immediate correction with transfusion is not necessary, the pathways guide the clinician through an assessment of the potential risk of requiring transfusion, as well as an
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Contact: Todd Ringler
617-577-8110
Feinstein Kean Healthcare
3-Apr-2002