Anemia in Neoplastic Disease: Current Treatment Options

Abstract

Anemia is one of the most common complications of cancer. The severity of anemia depends on the severity of the disease and the course of its development. The review of the literature presents the causes and mechanisms of anemia in patients with malignant neoplasms, discussing its negative impact not only on the quality of life, but also on the effectiveness of chemotherapy, existing clinical recommendations for the treatment of anemia with the use of erythropoiesis stimulating agents. The attention is paid to the effectiveness of modern intravenous iron preparations. A brief overview of the literature data on the problem of use of intravenous iron preparations in clinical practice is presented. The review includes mainly the data of controlled randomized clinical studies, which are considered to be most informative in evidence. Recently, effective and safe intravenous iron preparations have appeared, the ways of their introduction, doses and formulas have been developed to calculate the overall deficit of iron in the organism. The data on the anemia importance, the incidence of which in tumor diseases, increases constantly, were found. In numerous randomized studies that have taken place over the open protocol, the value of hemoglobin (Hb) level for the quality of life of cancer patients receiving chemotherapy is demonstrated. Before recombinant human erythropoietins (rHuEPO) the transfusion of erythrocyte mass was used in cancer patients with anemia. However, hemotransfusion could be accompanied by the development of complications, transmission of transmissible infections, post-transfusion reactions, aloimmunization and the effect on the tumor clone with the possibility of stimulating tumor growth. The safety of iron parenteral preparations has increased because of the creation of a new generation of iron drugs.