Anaemia and its management in cancer patients

Almost a third of cancer patients are anaemic at diagnosis and more than half become anaemic during treatment. Anaemia can have a significant impact on quality of life and survival. Its development is multifactorial and may be a direct or indirect result of the malignant tumour or a side effect of anti-tumour treatment. Clarifying the aetiology is key to choosing the appropriate treatment. Therapeutic options include stimulation of erythropoiesis, iron replacement and transfusion. The choice between curative or palliative anticancer treatment is an important consideration. We also need to consider the specificity of the tumour, the severity of symptoms, the side effect profile of each drug, co-morbidities and the cost of therapy. All of these must be assessed together to make a personalised decision. In this article, the authors summarise the possible causes and treatment options for tumour-associated anaemia, based on international recommendations, clinical trials and literature data.