Abstract
Interest in the efficacy and potential deleterious consequences of treatment with erythropoietic-stimulating agents (ESAs) is very high. Recently, the ESAs have come under intense scrutiny as several clinical trials have shown their use to be associated with an increased risk of thrombosis, and a concern for increased mortality risk in oncology. In this context, attention to the effect of ESAs upon fatigue and other aspects of quality of life has tended to be lost. To aid inclusion of this endpoint in the important consideration of risks and benefits of ESA therapy, we summarize the many reviews that have been conducted on this topic. The ten selected reviews were all conducted systematically or were otherwise comprehensive. While these reviews acknowledge an overall positive fatigue or quality-of-life effect, some were equivocal about the meaningfulness or magnitude of the benefit. The overall evidence from these reviews supports a fatigue and overall quality-of-life benefit from treatment with ESAs that is unlikely to be due to chance. This information should be included in the risk/benefit consideration of these controversial agents.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rizzo JD, Somerfeld MR, Hagerty KL, Seidenfeld J, Bohlius J, Bennett CL, et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update. J Clin Oncol. 2008;26:132–49.
Bohlius J, Wilson J, Seidenfeld J, Piper M, Schwarzer G, Sandercock J, et al. Recombinant human erythropoietins and cancer patients: updated meta-analysis of 57 studies including 9353 patients. J Natl Cancer Inst. 2006;98:708–14.
Jones M, Schenkel B, Just J, Fallowfield L. Epoetin alfa improves quality of life in patients with cancer: results of a meta-analysis. Cancer. 2004;101:1720–32.
Bohlius J, Langensiepen S, Schwarzer G, Seidenfeld J, Piper M, Bennet C, et al. Erythropoietin for patients with malignant disease (review). Cochrane Database Syst Rev. 2005;4:1–153.
Bohlius J, Wilson J, Seidenfeld J, Piper M, Schwarzer G, Sandercock J, et al. Erythropoietin or darbepoetin for patients with cancer. Cochrane Database Syst Rev. 2006;3:1–228.
Seidenfeld J, Piper M, Bohlius J, Weingart O, Trelle S, Engert A, et al. Comparative effectiveness of epoetin and darbepoetin for managing anemia in patients undergoing cancer treatment. Comparative effectiveness review no. 3. Agency for Healthcare Research & Quality, May 2006.
Ross SD, Allen E, Henry DH, Seaman C, Sercus B, Goodnough LT. Clinical benefits and risks associated with epoetin and darbepoetin in patients with chemotherapy-induced anemia: a systematic review of the literature. Clin Ther. 2006;28:1–31.
Wilson J, Yao GL, Raftery J, Bohlius J, Brunskill S, Sandercock J, et al. A systematic review and economic evaluation of epoetin alfa, epoetin beta and darbepoetin alfa in anaemia associated with cancer, especially that attributable to cancer treatment. Health Technol Assess. 2007;11:1–220.
Quirt I, Bramwell V, Charette M, Oliver T. The role of erythropoietin in the management of cancer patients with non-hematologic malignancies receiving chemotherapy. Practice guideline report #12-1. Toronto, ON: Cancer Care Ontario, 2007.
Shehata N, Walker I, Meyer R, Haynes AE, Imrie K. Treatment for anemia with erythropoietic agents in patients with non-myeloid hematological malignancies. A clinical practice guideline. Toronto, ON: Cancer Care Ontario, 2007.
Kimel M, Leidy NK, Mannix S, Dixon J. Does epoetin alfa improve health-related quality of life in chronically ill patients with anemia? Summary of trials of cancer, HIV/AIDS, and chronic kidney disease. Value Health. 2008;11:57–75.
Minton O, Stone P, Richardson A, Sharpe M, Hotopf M. Drug therapy for the management of cancer-related fatigue. Cochrane Database Syst Rev. 2008;1:1–43.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Eton, D.T., Cella, D. (2010). Do Erythropoietic-Stimulating Agents Relieve Fatigue? A Review of Reviews. In: Lyman, G., Dale, D. (eds) Hematopoietic Growth Factors in Oncology. Cancer Treatment and Research, vol 157. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-7073-2_11
Download citation
DOI: https://doi.org/10.1007/978-1-4419-7073-2_11
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-7072-5
Online ISBN: 978-1-4419-7073-2
eBook Packages: MedicineMedicine (R0)