Increasingly,
anemia is being recognized as a negative prognostic and predictive factor for patients undergoing
chemotherapy,
radiation therapy, or a combination of these treatment modalities. The results of clinical studies have shown correlations between
anemia and shorter survival times in patients with a wide variety of solid
tumors and
hematologic malignancies, including lung, ovarian, breast, and head/
neck cancers,
non-Hodgkin's lymphoma,
Hodgkin's disease,
Waldenstrom's macroglobulinemia, and
chronic lymphocytic leukemia. Also,
anemia has been shown to predict treatment response in patients with ovarian, cervical, and urothelial
cancers,
mantle cell lymphoma, and
chronic lymphocytic leukemia, as well as refractory/relapsed
acute myelogenous leukemia. Based on the presumed causal relationship between
anemia and poor patient outcome, several studies have examined the influence of
epoetin alfa (a recombinant human
erythropoietin) on outcomes in anemic patients undergoing
cancer treatment. The results of these studies have been encouraging, with indications of greater locoregional
tumor control and higher response rates in
epoetin alfa-treated patients. Additionally,
epoetin alfa therapy, by correcting
anemia, has been shown to improve a patient's energy level, ability to perform daily activities, and overall quality of life (QOL). Such effects not only enhance a patient's general well-being, but may also increase their tolerance of, and willingness to undergo, full courses of their
cancer therapy in a timely manner. These findings support the use of
epoetin alfa to achieve gains in QOL and
cancer treatment outcomes in anemic
cancer patients and suggest that additional studies be conducted to further investigate the potential benefits of this agent in regard to improved outcomes.