Clinical practice guidelines for use of erythropoiesis stimulating agents (ESAs) from the American Society of Hematology (ASH) and the American Society of Clinical Oncology (ASCO) were updated in 2010 :
- ESAs should NOT be used for patients with cancer and anemia unassociated with chemotherapy. Use of ESAs in patients with lower-risk myelodysplastic syndromes to avoid transfusion is an exception to this recommendation.
- For patients undergoing myelosuppressive chemotherapy who have a hemoglobin value of <10 g/dL, clinicians should discuss potential benefits and harms of ESAs compared with red blood cell transfusion.
- The hemoglobin should be increased to the lowest concentration needed to avoid transfusion. ESAs should be discontinued if there is no response within six to eight weeks.
Source:
- Rizzo JD, Brouwers M, Hurley P, et al. American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer. Blood 2010; 116:4045.
- Rizzo JD, Brouwers M, Hurley P, et al. American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer. J Clin Oncol 2010; 28:4996.