Disorders of Blood Cell Production in Clinical Oncology
Summary of Key Points
• Anemia is very common in patients with cancer and is multifactorial.
• The anemia of persons with chronic disease is associated with decreased absorption of oral iron and decreased ability to access storage iron pools.
• Iron-restricted erythropoiesis may limit the efficacy of erythropoietic agents for the treatment of anemia in these patients and can be overcome with parenteral iron.
• Treatment of anemia in patients with cancer reduces transfusions and symptoms of anemia.
• Erythropoietic agent therapy is associated with an increased risk of venous thromboembolism.
• Neutropenia in patients with cancer is usually due to treatment.
• Myeloid growth factors can be used to reduce infection risk in patients for whom the risk is significant, and use of these growth factors is preferable to delaying or reducing the dose of chemotherapy when prolonging life is the intent.
• New agents for the stimulation of platelet production are in clinical development.
• Biosimilar preparations for commonly utilized hematopoietic growth factors will be appearing on the U.S. market. It will be important for oncologists to participate responsibly in postmarketing surveillance programs.
1. The anemia of chronic illness is usually associated with:
A A relatively low reticulocyte count
B Increased gastrointestinal absorption of dietary iron or supplemental oral iron
C Decreased access to storage iron pools
