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The treatment of anemia depends upon the cause. If the anemia is due to a lack of red blood cells, then red blood cells can be given through transfusions or treatment.
Red blood cell transfusions are used a lot of the time to treat anemia caused by cancer or its treatment when the hemoglobin is less than 8g/dL, the hematocrit less than 25%, or the person has symptoms. Red blood cells are looked at closely before they are given to someone to make sure that they match the person getting them. However, people can still have reactions to the red blood cell transfusion. To lower the chance that this happens, a special blood filters is usually used to administer the blood transfusion, or the red blood cells are irradiated. Some people don't want red blood cell transfusions for cultural reasons, such as people of the Jehovah's Witness faith.
PROCRIT can sometimes help these people become less anemic without red blood cell transfusions. This is made in the laboratory using special (recombinant DNA) methods so that it is identical to the body's erythropoietin. When epoetin alfa is given, it can take approximately four weeks to raise the hemoglobin and hematocrit.
For most people receiving chemotherapy that have been diagnosed with anemia, PROCRIT can be given to improve hemoglobin and reduce red blood cell transfusions (Cascinu et al, 1995).
Keeping a person's hemoglobin above 12 g/dL has other benefits as well. Cella (1998) studied patients with anemia at Rush-Presbyterian-St. Luke's Medical Center in Chicago and found that people with hemoglobin levels higher than 12 g/dL had fewer symptoms of anemia such as fatigue, shortness of breath, and fast heartbeat. Demetri from the Dana Farber Cancer Center and colleagues (1998) studied over 2200 people receiving chemotherapy, and found that PROCRIT improved hemoglobin values.
If a person has anemia due to iron or folate deficiency, then the person will need to take supplements and change their diet to eat more foods high in iron or folate. Foods high in iron are green leafy vegetables, organ meats including liver, nuts, egg yolks, molasses, whole grain cereals, shellfish, apricots, peaches, potatoes, prunes, and grapes. Foods high in folate are green leafy vegetables, asparagus, bananas, fish, oatmeal, beef liver, wheat bran, and peanut butter (Lynch, 2001).
PROCRIT is for chemotherapy-related anemia in patients with most types of cancer.
PROCRIT is proven and safe. PROCRIT is available by prescription only and is injected by your doctor or nurse. In studies, diarrhea, edema, fever, vomiting, shortness of breath, tingling, and upper respiratory infection occurred more often with PROCRIT than placebo. Although high blood pressure has been noted rarely in cancer patients treated with PROCRIT, blood pressure should be monitored carefully, particularly in patients with a history of high blood pressure or heart disease.
References:
Ortho Biotech (1999) Procrit (Epoetin alfa) Package Insert. Raritan NJ: Ortho Biotech IncYellen SB, Cella DF, Webster K et al Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system J Pain Symptom Manage 1997; 13(2): 63-74
Belcher AE Erythrocyte disorders. In: Belcher AE, ed. Blood Disorders. St Louis, MO: Mosby-Year Book; 1993.
Cascinu S, Del Ferro E, Fedeli A Recombinant human erythropoietin treatment in elderly cancer patients with cisplatin-associated anemia. Oncology 1995; 52: 422-430
Cella D Factors influencing quality of life in cancer patients: anemia and fatigue Seminars in Oncology 1998; 25(3 Suppl 7): 43-46
Demetri GD, Kris M, Wade J et al Quality of life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response of tumor type; Results from a prospective community oncology study J Clin Oncol 1998; 16(10): 3412-3425Grogan M, Thomas GM, Melamed I et al The importance of hemoglobin levels during radiotherapy for carcinoma of the cervix Cancer 1999; 86(6):1528-1536
Lee WR, Berkey B, Marcial V et al. Anemia is associated with decreased survival and increased locoregional failure in patients with locally advanced head and neck carcinoma: a secondary analysis of RTOG 85-27 Int J Radiat Oncol Biol Phys 1998; 1069-1075
Lynch MP Anemia. Chapter 12 in Camp-Sorrell D and Hawkins RA, eds. Clinical Manual for the Oncology Advanced Practice Nurse Pittsburgh, PA: Oncology Nursing Press, Inc.