Agents in the
Management of Anemia in Patients
Achievements and Challenges
Release DateOctober 2003
Expiration DateOctober 31, 2004
Nail, PhD, RN, FAAN
Professor and Senior Scientist
Oregon Health & Science University School of Nursing
in people with cancer is not well understood and continues to be suboptimally
treated. Anemia has a direct impact on patient-perceived quality of
life (QOL), and diminished QOL can ultimately affect a patients
willingness to continue cancer therapy. Conversely, studies show that
a rise in hemoglobin level correlates with improved QOL. The management
of anemia in patients with cancer has shifted dramatically over the
past 2 decades. Transfusion, with its attendant risks for infection
and transfusion reactions, is used less frequently, and clinical practice
guidelines emphasize the importance of anemia correction with erythropoietic
agents. Increasing evidence indicates a benefit of earlier intervention
with erythropoietic agents and more flexible dosing regimens. In addition,
a growing body of evidence suggests that erythropoietic agents may
potentially reduce cognitive dysfunction related to chemotherapy and/or
anemia, provide neuroprotection, and improve cancer treatment outcomes.
This article reviews current data supporting the optimal use of erythropoietic
agents, ie, epoetin alfa and darbepoetin alfa, in managing chemotherapy-induced
anemiaan issue of utmost importance to patients experiencing
the debilitating effects of this condition.
educational activity is intended for physicians, pharmacists, and
nurses involved in the management of patients with cancer.
completion of this activity, the participant should be able to:
the evolution of management strategies for chemotherapy-induced
anemia over the last 20 years
Assess the relationships between anemia, fatigue, and quality
of life in cancer patients
the role that erythropoietic agents play in the treatment of
Incorporate appropriate assessment and treatment strategies
for patients with chemotherapy-induced anemia into clinical
activity should take approximately 1 hour to complete. The participant
should, in order, read the objectives and monograph, answer the online
multiple-choice post-test, and complete the online answer form, registration,
and evaluation at the end of this activity. This credit is valid through
October 31, 2004.
has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical
Education through the joint sponsorship of the University of Kentucky
College of Medicine and McMahon Publishing Group. The University
of Kentucky College of Medicine is accredited by the ACCME to provide
continuing medical education for physicians.
The University of Kentucky College of Medicine designates this educational
activity for a maximum of 1 category 1 credit toward the AMA Physicians
Recognition Award. Each physician should claim only those credits
that he/she actually spent in the activity.
The University of Kentucky College of Medicine presents this activity
for educational purposes only. Participants are expected to utilize
their own expertise and judgment while engaged in the practice of
medicine. The content of the presentations is provided solely by
presenters who have been selected for presentations because of recognized
expertise in their field.
OF UNLABELED USE
activity contains discussion of published and/or investigational
uses of darbepoetin alfa and epoetin alfa; some uses of these agents
have not been approved by the FDA. Please refer to the official
prescribing information for each product for discussion of approved
indications, contraindications, and warnings.
OF FINANCIAL INTEREST
faculty members participating in continuing medical education programs
jointly sponsored by the University of Kentucky Colleges of Pharmacy
and Medicine Continuing Education Office are expected to disclose
any real or perceived conflict of interest related to the content
of their presentations.
Dr. Nail is a member of the speakers bureau for Ortho
Biotech Products, LP. She is a member of the DOSE Study Advisory
Committee for Ortho Biotech Products, LP, and is on the Board of
the National Anemia Council (grant funding from Amgen Inc).
This monograph was drafted by James Prudden, who has no relationships
to disclose. The content of this activity was controlled and approved
by the faculty.
(v5.5 or greater) or Netscape
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Windows 98, SE or above; OR Mac OS 10.2; 800 x 600 minimum monitor
resolution (1024 x 768 recommended)
sponsored by the University of Kentucky College of Medicine and McMahon
activity is supported through an unrestricted educational grant from
Ortho Biotech Products, LP.
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