Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology.

Published this month in Blood and the Journal of Clinical Oncology are the much discussed and debated guidelines of a blue ribbon panel on the evidence-based use of erythropoietin in the anemia of cancer. Well-referenced and well-discussed, these guidelines will help to focus the debate on the appropriate use of erythropoietin in the anemic cancer patient. As discussed, quality of life is often improved in the responding patient. While doses are detailed in the review, they represent only those doses used in the original studies. Studies underway now or just completed will better define the best doses and frequencies, such as “front loading” to achieve faster responses and less frequent but higher doses maintenance schedules. Still to be worked out are the issues of response prediction and the appropriate use of iron. Stay tuned…

– D. H. Henry