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Published online: 2023-09-12
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Anemia in cancer patients: addressing a neglected issue - diagnostics and therapeutic algorithm

Konrad Tałasiewicz1, Aleksandra Kapała12
DOI: 10.5603/njo.96928
Affiliations
  1. Department of Oncology Diagnostics, Cardio-Oncology and Palliative Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  2. Department of Clinical Nutrition, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

open access

Ahead of print
Nutrition in oncology
Published online: 2023-09-12

Abstract

Cancer-related anemia (CRA) continues to be a critical concern despite advancements in oncology treatments. The prevalence of anemia varies from 30% to 90%, impacting the quality of life and prognosis of cancer patients. While CRA is often attributed to antineoplastic therapies, it can also result from the disease itself. Inflammation and the iron regulatory hormone hepcidin play significant roles in CRA pathogenesis. Treatment-induced anemia caused by chemotherapy, tyrosine kinase inhibitors (TKIs) and immunotherapy, pose additional challenges. Intravenous (IV) iron has emerged as an effective treatment option for CRA, overcoming limitations associated with oral iron supplementation. Combining IV iron and ESAs enhances treatment outcomes. Future directions involve exploring ESA safety and their immunomodulatory effects. Transfusions provide quick relief but might impact prognosis and immune response. Other considerations include incorporating physical activity and exploring hepcidin-directed therapy. In conclusion, CRA management necessitates a multifaceted approach to address deficiencies, optimize therapies and improve patient outcomes.

Abstract

Cancer-related anemia (CRA) continues to be a critical concern despite advancements in oncology treatments. The prevalence of anemia varies from 30% to 90%, impacting the quality of life and prognosis of cancer patients. While CRA is often attributed to antineoplastic therapies, it can also result from the disease itself. Inflammation and the iron regulatory hormone hepcidin play significant roles in CRA pathogenesis. Treatment-induced anemia caused by chemotherapy, tyrosine kinase inhibitors (TKIs) and immunotherapy, pose additional challenges. Intravenous (IV) iron has emerged as an effective treatment option for CRA, overcoming limitations associated with oral iron supplementation. Combining IV iron and ESAs enhances treatment outcomes. Future directions involve exploring ESA safety and their immunomodulatory effects. Transfusions provide quick relief but might impact prognosis and immune response. Other considerations include incorporating physical activity and exploring hepcidin-directed therapy. In conclusion, CRA management necessitates a multifaceted approach to address deficiencies, optimize therapies and improve patient outcomes.

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Keywords

anemia, cancer, hepcidin, erythropoiesis-stimulating agents, blood transfusions

About this article
Title

Anemia in cancer patients: addressing a neglected issue - diagnostics and therapeutic algorithm

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Review paper

Published online

2023-09-12

Page views

21

Article views/downloads

13

DOI

10.5603/njo.96928

Keywords

anemia
cancer
hepcidin
erythropoiesis-stimulating agents
blood transfusions

Authors

Konrad Tałasiewicz
Aleksandra Kapała

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