Anaemia in elderly patients with cancer: Focus on chemotherapy-induced anaemia

Anaemia in general is known to cause fatigue, impaired physical performance, higher risk of falls, prolonged duration of hospitalisation, poor mood, and impaired cognitive function. In patients with cancer, chemotherapy-induced anaemia (CIA) is common, and has also been shown to affect patients' quality of life (QoL). In elderly patients, where up to 60% will develop CIA, the negative impact of these factors on QoL is even more pronounced. This has been recognised by the International Society of Geriatric Oncology (SIOG) and the American Society of Clinical Oncology (ASCO) who both recommend that CIA in elderly patients should be treated. However, due to the biological age and comorbidities of this patient population, careful consideration of potential therapy, concomitant to chemotherapy, is required. Indeed, as we begin to uncover the specific needs of this population of patients with cancer, it is also important to understand whether currently available treatment modalities are still appropriate. In this article, we explore the current evidence in elderly patients for the use of three of the most common therapies for the treatment of CIA: red blood cell transfusions, iron supplementation, and erythropoiesis-stimulating agents. (C) 2012 Elsevier Ltd. All rights reserved.