Assessing the impact of cancer-related anaemia on quality of life and the role of rHuEPO

Anaemia is a common and debilitating feature of malignancy that negatively impacts quality of life (QoL). QoL is multidimensional, usually comprising physical, emotional, social and cognitive functioning, although it may be supplemented with more specific aspects of well-being. QoL is also a highly subjective dynamic parameter, in that it changes as a function of time and conditions. For meaningful interpretation of results, therefore, the components of QoL and conditions must be listed and standardised. Existing guidelines should be followed on when QoL is a valid parameter to include in a trial design and which QoL instrument to use. General scales that can be customised, such as the European Organization for Research and Treatment of Cancer (EORTC) and Functional Assessment of Cancer Therapy-General (FACT-G) Instruments, are recommended. QoL should be assessed at least three times over the course of a study, with lower frequencies of assessment and simple assessment methods being key to compliance. Studies assessing the effect of recombinant human erythropoietin (rHuEPO) on anaemia and QoL have used various QoL instruments but agree that there is a positive correlation between haemoglobin value and QoL. When QoL assessment is correctly carried out, it can supplement standard endpoints, such as survival and response, and lead to more informed decisions concerning cost:benefit ratios.