Chemotherapy Induced Anemia

Question 1

What are the general causes of anemia? (4)

Answer 1

decreased RBC production; decreased erythropoietin production; blood loss; decreased stores of Vit B12, iron, or folic acid

Question 2

What patients should undergo a work-up for anemia?

Answer 2

Hgb < 11 g/dL or > 2 g/dL drop from baseline

Question 3

What should you do if a patient has symptomatic anemia?

Answer 3

transfuse as indicated; perform iron studies; consider ESAs

Question 4

Why do we need to perform an iron study prior to ESA therapy?

Answer 4

ESAs will not work if iron stores are depleted.

Question 5

ESAs are not recommend in what patient populations? (3)

Answer 5

patients receiving myelosuppressive chemotherapy with curative intent; patients with cancer not receiving chemotherapy; patients receiving non-myelosuppresive chemotherapy

Question 6

List the things you need to know about iron supplementation. (2)

Answer 6

always do a test dose; total course of treatment should be 1000 mg