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Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-06-1767. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-06-1767v1 100/7/2303    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Rizzo, J. D. Articles by Gordon, M. S. Search for Related Content PubMed PubMed Citation Articles by Rizzo, J. D. Articles by Gordon, M. S. Related Collections Review Articles Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 October 2002, Vol. 100, No. 7, pp. 2303-2320 REVIEW ARTICLE Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology J. Douglas Rizzo, Alan E. Lichtin, Steven H. Woolf, Jerome Seidenfeld, Charles L. Bennett, David Cella, Benjamin Djulbegovic, Matthew J. Goode, Ann A. Jakubowski, Stephanie J. Lee, Carole B. Miller, Mark U. Rarick, David H. Regan, George P. Browman, and Michael S. Gordon From the Medical College of Wisconsin, Milwaukee, WI; Cleveland Clinic Foundation, Cleveland, OH; Virginia Commonwealth University, Richmond, VA; Blue Cross and Blue Shield Association Technology Evaluation Center, Chicago, IL; VA Chicago Health Care System, Chicago, IL; Evanston Northwestern Healthcare, Evanston, IL; H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida, Tampa, FL; Mesa, AZ (patient representative); Memorial Sloan-Kettering Cancer Center, New York, NY; Dana Farber Cancer Institute, Boston, MA; Saint Agnes Hospital, Baltimore, MD; NW Kaiser Permanente, Portland, OR; Northwest Cancer Specialists, Portland, OR; Hamilton Regional Cancer Center, Hamilton, Ontario, Canada; and University of Arizona Health Sciences Center, Phoenix, AZ. Anemia resulting from cancer or its treatment is an important clinical problem increasingly treated with the recombinant hematopoietic growth factor erythropoietin. To address uncertainties regarding indications and efficacy, the American Society of Clinical Oncology and the American Society of Hematology developed an evidence-based clinical practice guideline for the use of epoetin in patients with cancer. The guideline panel found good evidence to recommend use of epoetin as a treatment option for patients with chemotherapy-associated anemia with a hemoglobin (Hgb) concentration below 10 g/dL. Use of epoetin for patients with less severe anemia (Hgb level below 12 g/dL but never below 10 g/dL) should be determined by clinical circumstances. Good evidence from clinical trials supports the use of subcutaneous epoetin thrice weekly (150 U/kg) for a minimum of 4 weeks. Less strong evidence supports an alternative weekly (40 000 U/wk) dosing regimen, based on common clinical practice. With either administration schedule, dose escalation should be considered for those not responding to the initial dose. In the absence of response, continuing epoetin beyond 6-8 weeks does not appear to be beneficial. Epoetin should be titrated once the hemoglobin concentration reaches 12 g/dL. Evidence from one randomized controlled trial supports use of epoetin for patients with anemia associated with low-risk myelodysplasia not receiving chemotherapy; however, there are no published high-quality studies to support its use for anemia in other hematologic malignancies in the absence of chemotherapy. Therefore, for anemic patients with hematologic malignancies it is recommended that physicians initiate conventional therapy and observe hematologic response before considering use of epoetin. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Guidelines for the use of epoetin in cancer patients: a much-needed step forward in standardizing anemia treatment David H. Henry Blood 2003 102: 2697-2698. 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