The May 26 research article “Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis” 1 suggested that none of the studies that reported mortality used erythropoiesis-stimulating agents in a manner consistent with the current Health Canada label for darbepoetin. That was incorrect. The paragraph should read as follows:
Current practices for the use of erythropoiesis-stimulating agents in people with cancer-related anemia are more restrictive than they once were. Guidelines from the American Society of Clinical Oncology indicate that the agents should not be used unless patients are receiving concurrent chemotherapy; however, they cautiously recommend their use when the hemoglobin level is less than or approaching 100 g/L (or 100–120 g/L in certain circumstances, including decreased cardiopulmonary reserve). The recently revised Health Canada label for darbepoetin is similar to the society’s criteria: it indicates that the agent should be used for cancer-related anemia under very specific conditions: the presence of nonmyeloid cancer; anemia due to chemotherapy; a hemoglobin level less than 100 g/L; and a target hemoglobin level of no more than 120 g/L. Although we identified 2 studies that reported mortality and met the last 3 conditions (and were therefore consistent with the American Society of Clinical Oncology’s criteria), both enrolled patients with a hematological malignancy (multiple myeloma).
Footnotes
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For the full paper, go to: www.cmaj.ca/cgi/content/full/180/11/E62
REFERENCE:
- 1.