Anemia with hemoglobin < 11.0 mg/l is normal during chemotherapy. This will often lead to prominent fatigue. Anemia can be treated symptomatically with transfusion of erythrocytes, or bone marrow can be stimulated with erythropoitin (EPO).
Patients with chemotherapy-induced anemia will usually have sufficient iron storage, but some may need iron supplementation.
Anemia should normally not cause postponement of treatment. It is quickly corrected by an erythrocyte transfusion – and treatment may then be started.
- Patients with chemotherapy-induced anemia
- Hypersensitivity to darbepoetin alfa, r-HuEPO or any of the additional ingredients.
- Poorly-controlled hypertension
- Reduced liver function (raised s-bilirubin). EPO is most likely eliminated via the liver. There is presently no toxicity data on patients with reduced liver function.
- Some studies indicate a detrimental effect on patient survival by the use of EPO in cancer patients, and this treatment should be avoided for anemia in cancer patient for whom there is a curative goal with the treatment.
- Reach hemoglobin level of 12–13 g/l