Anemia has been reported in approximately 40%-70% of patients with
hematologic malignancies, with severity depending on the type and stage of disease and whether the patient has received myelosuppressive
chemotherapy. Growing evidence supports the role of
epoetin alfa in correcting
anemia and improving quality of life (QOL) in patients with
hematologic malignancies. Clinical practice guidelines recommend the use of
epoetin alfa in patients with
cancer-related
anemia (including patients with
hematologic malignancies) and
hemoglobin levels < or =10 g/dL.
Epoetin alfa treatment is optional for patients with
cancer-related
anemia and
hemoglobin levels>10 g/dL and <12 g/dL, depending on clinical circumstances. A prospective, open-label, randomized trial evaluating hematologic response, transfusion use, and QOL after immediate or delayed
epoetin alfa treatment in mildly anemic patients (
hemoglobin< or =12 g/dL) undergoing
chemotherapy for
chronic lymphocytic leukemia,
multiple myeloma, or
lymphoma was recently completed. Study objectives included determining any correlation between changes in
hemoglobin level and QOL and assessing any correlation between QOL measures and health care resource use. Interim results suggest that
epoetin alfa treatment in patients with hematologic
cancers and
hemoglobin< or =12 g/dL who are receiving
chemotherapy increases
hemoglobin, functional capacity, well-being, work and productivity, and health resource use. Further evaluation of alternative
epoetin alfa dosing schedules and use of
epoetin alfa in treating
anemia in patients with specific
hematologic malignancies is ongoing.