# Anaemia

Source: https://onco.cc/terms/anaemia/  
OnCo record `anaemia` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A shortage of red blood cells or haemoglobin, causing tiredness and breathlessness. In cancer it comes from the disease itself (marrow infiltration, bleeding, inflammation), from chemotherapy suppressing the marrow, and from some targeted drugs.

## Summary

Present in 30-90% of patients depending on cancer and treatment; a defining feature of myeloma, MDS and leukaemia, and the dose-limiting toxicity of PARP inhibitors (olaparib, talazoparib) and of some ADCs and radioligands. Managed by treating the cause, iron replacement, red cell transfusion (with restrictive thresholds) and, cautiously, erythropoiesis-stimulating agents, which raise thrombosis risk and were linked to worse outcomes when used to high targets. Transfusion independence is an endpoint in MDS trials (luspatercept, imetelstat). Fatigue from anaemia is one of the most common and under-treated symptoms in oncology.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: anemia; anaemic; anemic; low haemoglobin; low hemoglobin; haemoglobin; hemoglobin; transfusion-dependent; transfusion dependence; transfusion independence; red cell transfusion; erythropoiesis-stimulating agent; ESA; ESAs; iron deficiency; erythropoiesis-stimulating agents

## Notes

- Lung cancer: Cancer Research UK lists a low red blood cell count as a cause of breathlessness in lung cancer, explains that haemoglobin carries oxygen so a low level leaves the blood carrying less, and says anaemia can be due to the cancer or to a treatment such as chemotherapy. Macmillan says you may need a blood test to check and that some people need a transfusion. It is worth asking about, because it is one of the causes of breathlessness that can be corrected quickly.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Anemia
- Wikipedia: https://en.wikipedia.org/wiki/Anemia
- Cancer Research UK: coping with breathlessness when you have lung cancer: https://www.cancerresearchuk.org/about-cancer/lung-cancer/living-with/coping-with-breathlessness
- Macmillan: breathlessness: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/breathlessness

## Connected records

- terms: [Cytopenias and myelosuppression](https://onco.cc/terms/cytopenias/), [Fatigue after lymphoma treatment, and why it is a symptom to report](https://onco.cc/terms/lymphoma-living-fatigue/), [Thrombocytopenia](https://onco.cc/terms/thrombocytopenia/)
- cancers: [Lower-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-lower-risk/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Myelodysplastic syndromes / neoplasms (MDS)](https://onco.cc/cancers/mds/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Primary myelofibrosis](https://onco.cc/cancers/primary-myelofibrosis/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Transfusion support and anaemia management](https://onco.cc/technologies/transfusion-support/)
- drugs: [Imetelstat](https://onco.cc/drugs/imetelstat/), [Luspatercept](https://onco.cc/drugs/luspatercept/)
- targets: [Erythropoietin receptor (EPOR)](https://onco.cc/targets/epor/)

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