TUESDAY, Oct. 26 (HealthDay News) -- Physicians need to use
caution when giving a class of drugs called
erythropoiesis-stimulating agents (ESAs) to cancer patients who
have anemia caused by chemotherapy, according to new medical
And with rare exceptions, ESAs should not be given to cancer
patients who are not receiving chemotherapy, according to joint
guidelines issued by the American Society of Hematology and the
American Society of Clinical Oncology.
ESAs (marketed as Procrit, Epogen and Aranesp) stimulate the
bone marrow to produce more red blood cells but are associated with
shorter survival and increased risk of blood clots and tumor
progression, the guidelines noted.
However, ESAs reduce the need for red blood cell transfusions,
which carry a risk of serious infection and adverse reactions in
the immune system.
The guidelines offer specific recommendations on the use of
ESAs. Among them:
- ESAs should not be given to cancer patients who are not
receiving chemotherapy, except for those with myelodysplastic
- Doctors should discuss individual risks and benefits of ESAs
and blood transfusion with patients before therapy. This shared
decision-making is critical.
"This updated guideline offers clinicians the latest synthesis of the medical evidence surrounding the use of ESAs in patients with cancer, including appropriate cautions where evidence is lacking or where risks may outweigh the use of ESAs," guideline panel co-chair Dr. J. Douglas Rizzo, professor of medicine at the Medical College of Wisconsin, said in an American Society of Hematology news release.
"These guidelines touch on almost all aspects of the use of ESAs in patients with cancer and MDS, as well as secondary issues, such as the role of iron supplementation," Dr. Samuel Silver, a member of the ASH Committee on Practice and a professor of internal medicine at the University of Michigan, added in the news release.
The updated guidelines appear online Oct. 25 ahead of print in
the Nov. 18 issue of
Blood and the Nov. 20 issue of the
Journal of Clinical Oncology.
The U.S. Food and Drug Administration has more about