Significance of anemia in cancer chemotherapy

As a common symptom in cancer, anemia is often induced either directly or indirectly by the malignant disease itself or its treatment. The prevalence and incidence of anemia depend on one side on the type and stage of malignancy and on the other side on the type, schedule and intensity of treatment. Hematological malignancies, particularly myeloid disorders, are generally more often associated with anemia than solid tumors but, depending on the type of treatment, the latter may be associated with anemia and require red blood cell (RBC) transfusions in a similarly high proportion of patients (Skillings et al. 1993; Coiffier et al. 2001). Anemia and the need for transfusions are also more frequently associated with advanced stage of diseases than early stage (Durie and Salmon 1975; Binet et al. 1977; Moullet et al. 1998; Barrett-Lee et al. 2000). Preexisting anemia related to cancer or prior treatment usually worsens during radiotherapy and chemotherapy, and in a considerable number of patients, radiotherapy and chemotherapy as such produce anemia, primarily due to their myelosuppressive effect (Skillings et al. 1993, 1999; Sadahiro et al. 1998; Estrin et al. 1999; Groopman and Itri 1999; Moullet et al. 1998; Lammering et al. 1999; Barrett-Lee et al. 2000, 2006; Harrison et al. 2000; Coiffier et al. 2001; Ludwig et al. 2004; Ludwig in this book; Steurer et al. 2004; Kosmidis et al. 2005; Seshardi et al. 2005; Birgegard et al. 2006).