Chemotherapy-induced anemia in adults: Incidence and treatment

Anemia is a common complication of myelosuppressive chemotherapy that resul ts in a decreased functional capacity and quality of life (QOL) for cancer patients. Severe anemia is treated with red blood cell transfusions, but mi ld-to-moderate anemia in patients receiving chemotherapy has traditionally been managed conservatively on the basis of the perception that it was clin ically unimportant, This practice has been reflected in the relative inatte ntion to standardized and complete reporting of all degrees of chemotherapy -induced anemia. We undertook a comprehensive review of published chemother apy trials of the most common single agents and combination chemotherapy re gimens, including the new generation of chemotherapeutic agents, used in th e treatment of the major nonmyeloid malignancies in adults to characterize and to document the incidence and severity of chemotherapy-induced anemia. Despite identified limitations in the grading and reporting of treatment-re lated anemia, the results confirm a relatively high incidence of mild-to-mo derate anemia. Recent advances in assessing the relationships of anemia, fa tigue, and QOL in cancer patients are providing new insights into these clo sely related factors. Clinical data are emerging that suggest that mild-to- moderate chemotherapy-induced anemia results in a perceptible reduction in a patient's energy level and QOL, Future research may lead to new classific ations of chemotherapy-induced anemia that can guide therapeutic interventi ons on the basis of outcomes and hemoglobin levels, Perceptions by oncologi sts and patients that lesser degrees of anemia must be endured without trea tment may be overcome as greater emphasis is placed on the QOL of the oncol ogy patient and as research provides further insights into the relationship s between hemoglobin levels, patient well-being, and symptoms.