About 30% of patients with
tumors (in relation to its extent) suffer from
anemia which is usually asymptomatic. Etiologically this
anemia may be characterized as secondary, so called
anemia of
chronic diseases. Disorders of
iron metabolism, blood marrow insufficiency, extracorpuscular
haemolysis, catabolism of patients with
tumor burden and relative deficiency of
erythropoietin all play a role in its pathogenesis.
Anemia of
cancer patients may be usually classified as normocytic and normochromic. Indication and timing for treatment of
anemia of
cancer is equivocal. Successful treatment of
anemia seems to improve the quality of life of
cancer patients. Indication depends, of course, on the severity of
anemia, degree of adaptation and the presence of clinical symptoms related to
anemia.
Therapy with
iron or anabolics is not very effective,
therapy with recombinant
erythropoietin is not available for all patients, especially for its high price. Transfusion
therapy should be considered more carefully in relation with some data showing the possible negative influence of allogeneic blood derivatives on the progression of
tumors, especially in patients immunodeficient after high dose
chemotherapy and
actinotherapy.