Hemoglobin levels that trigger erythropoiesis-stimulating agent treatment decisions for cancer-associated anemia--examination of practice in Germany

Current Medical Research and Opinion
T SteinmetzA Tsamaloukas

Abstract

Given the safety concerns regarding off-label use of erythropoiesis-stimulating agents (ESAs) in the treatment of cancer-associated anemia, data from the German Cancer Anemia Registry (CAR) were analyzed to examine whether current practice in Germany adheres to treatment guidelines. CAR was a web-based registry gathering patient data for 12 weeks following anemia diagnosis or until the primary treatment objective was achieved. Of over 2000 patients surveyed, 783 were treated with ESAs. Treatment was primarily aimed at improvement of quality of life (37.3%), hemoglobin correction (32.7%), and prevention of transfusions (24.4%). The average hemoglobin level triggering ESA treatment was 9.7 g/dL (6.0 mmol/L), however, starting levels varied with cancer type. For 67.8% of patients, transfusions could be avoided. ESA treatment was stopped at 11.2 g/dL (7.0 mmol/L) and maximum hemoglobin levels during the study averaged 11.8 g/dL (7.3 mmol/L). In 4.8% of the women and 6.0% of the men, maximum hemoglobin levels were >14 g/dL (8.7 mmol/L); in 15.6% and 9.1%, respectively, levels were between 13 and 14 g/dL. The median hemoglobin level triggering transfusion was 8.3 g/dL (5.2 mmol/L), irrespective of the malignant disease. Current use o...Continue Reading

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Citations

Aug 4, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jason D WrightDawn L Hershman
Apr 5, 2013·Therapeutic Advances in Hematology·H Tilman Steinmetz
Apr 17, 2014·Journal of Oncology Practice·Dawn L HershmanJason D Wright

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