Erythropoietin in pediatric hematology and oncology

Of children and adolescents with malignant diseases, 80% are already anemic at the time of diagnosis. The pathophysiology of the development of anemia by malignant diseases is complex. Although anemia represents a potentially life threatening complication, less attention is paid to the effect on the physical, psychological and social status of the children. The main therapy option is a blood transfusion, which is immediately effective but has, however, a limited duration of effectiveness. In addition there is a risk of undesired acute and chronic transfusion reactions, in particular from infectious complications. Erythropoietin has been used successfully for 25 years as an adjunct to cure or alleviate anemia due to malignant diseases in adulthood. Since the middle of the 1990s several well-structured studies have been carried in childhood and adolescence. The question is, whether erythropoietin should also be considered a preferred alternative for the treatment of anemia by malignant diseases in children and adolescents.