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September 2007 Update on EORTC Guidelines and Anemia Management with Erythropoiesis-Stimulating Agents

^aMultidisciplinary Oncology Institute, Genolier, Switzerland; ^bDepartment of Internal Medicine, Westpfalz Klinikum, Kaiserslautern, Germany

Key Words. Anemia • Erythropoiesis-stimulating agents • 2007 EORTC guidelines

Correspondence: Matti S. Aapro, M.D., IMO Clinique de Genolier, 1 Route du Muids, 1272 Genolier, Switzerland. Telephone: 41223669106; Fax: 41223669131; e-mail: maapro{at}genolier.net

Disclosure: M. A. has received study grants and honoraria for consultancy and/or is on the speakers bureau of Amgen, Johnson and Johnson, Ortho Biotech, Sandoz, and Roche. H.L. has acted as a consultant for Amgen, Johnson and Johnson, and Biogenerix, and has received lecture fees from Amgen and Janssen-Cilag. No other potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

Anemia is frequently experienced by cancer patients receiving chemotherapy and can negatively impact the patient's prognosis. Blood transfusions, iron supplementation (in absolute or functionally iron-deficient anemias), and erythropoiesis-stimulating agents (ESAs) are among the treatment options for anemia. Treatment options for anemia management should be selected based on the best benefit-to-risk ratio for each individual patient. In September 2007, the working party of the European Organization for Research and Treatment of Cancer (EORTC) updated their guidelines on the use of ESAs, which are summarized in this paper. ESAs reduce the number of transfusions required and significantly improve quality of life in patients with chemotherapy-induced anemia. A sustained hemoglobin level of about 12 g/dl should be the target for treatment with ESAs. ESAs should be used according to the EORTC guidelines and within label with carefully considered exceptions.

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