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Red cell and platelet transfusions, iron and erythropoiesis-stimulating agents keep patients safe through chemotherapy and marrow failure; restrictive thresholds and ESA caution reflect trials showing more is not better.
Chemotherapy-induced anaemia affects most patients on myelosuppressive regimens; MDS and leukaemia patients are often transfusion-dependent. Evidence supports restrictive red cell thresholds (7-8 g/dL in stable patients; TRIST, Hb 7 vs 9 in haematologic malignancy) and prophylactic platelet transfusion at 10×10⁹/L (TOPPS showed prophylaxis still helps in most). ESAs (epoetin, darbepoetin) reduce transfusions but increased thromboembolism and mortality in several trials when Hb targets were high, so labels restrict them to palliative chemotherapy with Hb <10 g/dL (2007-08 FDA/EMA actions). IV iron improves ESA response and treats functional iron deficiency. Transfusional iron overload in MDS is treated with chelation (TELESTO). Newer agents: luspatercept and imetelstat (MDS), romiplostim/eltrombopag for chemotherapy-induced thrombocytopenia (off-label; avatrombopag trials), and thrombopoietin agonists after transplant. Blood supply and cost are limiting worldwide; pathogen-reduced platelets and cold-stored platelets are being adopted.
Replace or stimulate deficient blood components to prevent symptomatic anaemia, bleeding and infection while avoiding over-transfusion, alloimmunisation and ESA-related thrombosis.
Darbepoetin alfa (Aranesp) is a longer-acting version of erythropoietin given every one to three weeks to treat anaemia caused by chemotherapy, reducing transfusions but with the same warnings about clots and tumour growth as epoetin.
Epoetin alfa is a manufactured version of the kidney hormone that tells the bone marrow to make red blood cells. In cancer it treats anaemia caused by chemotherapy and reduces the need for transfusions, but it is used cautiously because it can shorten survival and cause clots.
Epoetin theta is a made-to-order version of erythropoietin, the hormone that tells the marrow to make red blood cells. It is used to treat the anaemia of chemotherapy in people with non-myeloid cancers, sparing some transfusions.
Imetelstat is a lipid-linked oligonucleotide that binds the RNA template of telomerase, the enzyme cancer cells use to stay immortal, and it is the first telomerase inhibitor approved for any cancer. In lower-risk myelodysplastic syndromes it freed 40% of transfusion-dependent patients from transfusions for at least eight weeks versus 15% on placebo, once growth factors have failed.
An injection that helps the marrow finish making red cells, reducing or removing the need for transfusions in lower-risk MDS and beta-thalassaemia.
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One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Query for this technology: (TITLE:"Transfusion support and anaemia management" OR ABSTRACT:"Transfusion support and anaemia management") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Transfusion support and anaemia management, not a curated reading list.
Shares Allogeneic stem cell transplantation, Myelodysplastic syndromes / neoplasms (MDS), Acute lymphoblastic leukaemia, Acute myeloid leukaemia and the tag supportive.
Shares Allogeneic stem cell transplantation, Myelodysplastic syndromes / neoplasms (MDS), Acute myeloid leukaemia and the tag supportive.
Shares Acute myeloid leukaemia in children, Acute lymphoblastic leukaemia and the tag supportive.
Shares Growth factors: G-CSF and febrile neutropenia prevention and the tag supportive.
Shares Acute lymphoblastic leukaemia, Acute myeloid leukaemia and the tag supportive.
Shares Growth factors: G-CSF and febrile neutropenia prevention and the tag supportive.
Shares Allogeneic stem cell transplantation and the tag supportive.
Shares Growth factors: G-CSF and febrile neutropenia prevention and the tag supportive.