Erythropoetin in urologic oncology

Objectives: The use of erythropoietin (EPO) for the treatment of anemia ass ociated with urological malignancies is not well defined. The rate of anemi a is dependent on the type of cancer and on the different types of treatmen t. Only with a substantial risk for blood transfusion is substitution treat ment by EPO justified. Additionally, the long-term risks of blood transfusi ons have to be balanced against the costs of EPO treatment. Methods: Different experts have reviewed the literature on anemia and EPO r egarding the four main tumor entities. Results/Conclusions: In prostate cancer, EPO treatment may be justified bef ore radical prostatectomy and in patients with advanced, hormone-refractory disease. In bladder cancer, significant treatment-related anemia mainly oc curs in patients who have to undergo radical cystectomy and in patients who will be treated with polychemotherapy for metastatic disease. Patients wit h renal cell carcinoma rarely suffer from anemia and thus are usually not c andidates for EPO treatment. Testis cancer patients only have a substantial risk for blood transfusions if they belong to the intermediate or poor pro gnosis group according to IGCCCG or if they need salvage chemotherapy or sa lvage surgery. However, in testis cancer patients EPO treatment should gene rally be preferred to blood transfusions since cure rates are excellent and thus the potential risks of transfusion-related infections are significant . Copyright (C) 2001 S. Karger AG, Basel.