An Update on Twenty Years of Anemia Management with Erythropoiesis-Stimulating Agents in Nephrology and Oncology/Hematology

Aapro, Matti

doi:10.1634/theoncologist.2009-s1-1

Cited by 10 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this meta-analysis, it was also demonstrated that the use of ESAs is associated with an increased risk of venous thromboembolism (odds ratio = 1.4) [26]. Regarding the increase in the risk for thromboembolic events [23, 27], it must be taken into account specially in patients with cardiovascular disease, in whom the ESA dose must be adjusted according to patient characteristics to avoid an excessive change in plasma volume and maintaining a consistent Hb level [28]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

et al. 2012

View full text Add to dashboard Cite

BackgroundThe present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain.MethodsThis was a multicenter, observational, cross-sectional study performed in 2008. Eligible patients were ≥18 years, with non-myeloid malignancies treated with systemic therapy [chemotherapy (CT), hormonal therapy or immunotherapy]. Anaemia was defined according to WHO as haemoglobin (Hb) < 12 g/dL.ResultsThe study included 214 patients with a median age of 63 years (range 20–91), 58 % women, 73 % with solid tumours, and 79 % with advanced disease. CT was used in 91 % of patients (26 % with platinum compounds), hormonal therapy in 8.5 %, and immunotherapy in 8.5 %. In our study, 48.1 % of patients [95 % confidence interval (CI) 45.2–58.6] showed anaemia (31 % symptomatic): 42.0 % mild (10 ≤ Hb ≤ 11.9 g/dL), 5.6 % moderate (8 ≤ Hb ≤ 9.9 g/dL), and 0.5 % severe (Hb < 8 g/dL). A higher prevalence was observed in patients treated with CT (51 vs. 20 %, p = 0.01), platinum-based CT (70 vs. 47 %, p = 0.01) or palliative CT (61 vs. 39 %, p = 0.003). Anaemia was also more frequent in patients with more than three lines of CT (83 %) and in the fourth or subsequent CT cycle (58 %). Management in the previous 4 weeks in patients with anaemia was: 62 % did not receive treatment (92 % mild), 24 % received erythropoiesis-stimulating agents (ESAs), 14 % received iron and 8.7 % received transfusion.ConclusionsIn Spanish hospitals, about half of patients with non-myeloid malignancies undergoing systemic therapy fulfilled anaemia criteria (87 % mild). Approximately two-third of patients with anaemia do not receive specific treatment and ESA use is below current guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Epoetin-α, epoetin-β, and darbepoetin-α, modified recombinant EPOs, are also available for clinical use. 75 These agents show similar effectiveness in clinical studies but have some pharmacokinetic differences. Darbepoetin-α boasts a longer half-life, which allows it to be administered every 2 or 3 weeks, although the time to achieve desired hemoglobin values may be longer than those for epoetin; agents with a shorter half-life require weekly administration.…”

Section: Therapeutic Approaches For Anemia In Patients With Cancermentioning

confidence: 99%

Experimental Drugs for Chemotherapy- and Cancer-Related Anemia

Madeddu¹,

Neri²,

Sanna³

et al. 2021

JEP

View full text Add to dashboard Cite

Anemia in cancer patients is a relevant condition complicating the course of the neoplastic disease. Overall, we distinguish the anemia which arises under chemotherapy as pure adverse event of the toxic effects of the drugs used, and the anemia induced by the tumour-associated inflammation, oxidative stress, and systemic metabolic changes, which can be worsened by the concomitant anticancer treatments. This more properly cancer-related anemia depends on several overlapping mechanism, including impaired erythropoiesis and functional iron deficiency, which make its treatment more difficult. Standard therapies approved and recommended for cancer anemia, as erythropoiesis-stimulating agents and intravenous iron administration, are limited to the treatment of chemotherapy-induced anemia, preferably in patients with advanced disease, in view of the still unclear effect of erythropoiesis-stimulating agents on tumour progression and survival. Outside the use of chemotherapy, there are no recommendations for the treatment of cancer-related anemia. For a more complete approach, it is fundamentally a careful evaluation of the type of anemia and iron homeostasis, markers of inflammation and changes in energy metabolism. In this way, anemia management in cancer patient would permit a tailored approach that could give major benefits. Experimental drugs targeting hepcidin and activin II receptor pathways are raising great expectations, and future clinical trials will confirm their role as remedies for cancer-related anemia. Recent evidence on the effect of integrated managements, including nutritional support, antioxidants and anti-inflammatory substances, for the treatment of cancer anemia are emerging. In this review article, we show standard, innovative, and experimental treatment used as remedy for anemia in cancer patients.

show abstract

“…ESAs, in addition to transfusions and iron therapy, are also usually used in clinical practice to improve anemia in patients with solid tumors and hematological malignancies receiving chemotherapy . ESAs have been approved for the treatment of chemotherapy‐induced anemia since 1993 . These drugs have been demonstrated to ameliorate hemoglobin levels and anemia‐related symptoms and to reduce the need for red blood cell transfusions.…”

Section: Recombinant Human Erythropoietin: Pharmaceutical Formulationmentioning

confidence: 99%

Erythropoiesis and chronic kidney disease–related anemia: From physiology to new therapeutic advancements

Cernaro

Coppolino

Visconti

et al. 2018

Medicinal Research Reviews

View full text Add to dashboard Cite

Erythropoiesis is triggered by hypoxia and is strictly regulated by hormones, growth factors, cytokines, and vitamins to ensure an adequate oxygen delivery to all body cells. Abnormalities in one or more of these factors may induce different kinds of anemia requiring different treatments. A key player in red blood cell production is erythropoietin. It is a glycoprotein hormone, mainly produced by the kidneys, that promotes erythroid progenitor cell survival and differentiation in the bone marrow and regulates iron metabolism. A deficit in erythropoietin synthesis is the main cause of the normochromic normocytic anemia frequently observed in patients with progressive chronic kidney disease. The present review summarizes the most recent findings about each step of the erythropoietic process, going from the renal oxygen sensing system to the cascade of events induced by erythropoietin through its own receptor in the bone marrow. The paper also describes the new class of drugs designed to stabilize the hypoxia-inducible factor by inhibiting prolyl hydroxylase, with a discussion about their metabolism, disposition, efficacy, and safety. According to many trials, these drugs seem able to simulate tissue hypoxia and then stimulate erythropoiesis in patients affected by renal impairment. In conclusion, the in-depth investigation of all events involved in erythropoiesis is crucial to understand anemia pathophysiology and to identify new therapeutic strategies, in an attempt to overcome the potential side effects of the commonly used erythropoiesis-stimulating agents.

show abstract

An Update on Twenty Years of Anemia Management with Erythropoiesis-Stimulating Agents in Nephrology and Oncology/Hematology

Cited by 10 publications

References 34 publications

Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

Experimental Drugs for Chemotherapy- and Cancer-Related Anemia

Erythropoiesis and chronic kidney disease–related anemia: From physiology to new therapeutic advancements

Contact Info

Product

Resources

About