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Ramon Mohanlal and Lan Huang

Introduction: Cancer patients (pts) with chronic anemia require long-term blood transfusions causing tissue iron (Fe) overload in the heart, liver, endocrine organs leading to morbidity and shortened life expectancy. Fe overload is usually treated

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Jennifer M. Hinkel, Edward C. Li and Stephen L. Sherman

(ESAs), blood transfusions, and iron supplementation to maintain hemoglobin levels in patients with cancer. Each of these interventions has complexities and, in some cases, controversies. Moreover, anemia and the interventions used to counter it can have

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Susana M. Campos, Mei Sheng Duh, Patrick Lefebvre and James Rosberg

Although previous studies have recognized that timely correction of anemia is desirable, no published research quantifies the association between the timeliness of the hemoglobin rise and patients' outcomes. This study evaluates whether anemic patients with cancer who are receiving chemotherapy and who experienced an early response to epoetin alfa (≥ 1 g/dL hemoglobin increase at the end of 4 weeks of treatment) experienced better clinical and drug utilization outcomes compared with patients who did not experience an early response. Three large, open-label, community studies of epoetin alfa for the treatment of chemotherapy-related anemia were retrospectively analyzed to assess the association of early hemoglobin response to subsequent transfusion requirements, subsequent hemoglobin response, quality of life, and epoetin alfa dosage administered over the study. Two epoetin alfa dosing regimens were evaluated: 10,000 units 3 times weekly with potential escalation to 20,000 units, and 40,000 units once weekly with potential escalation to 60,000 units. In all studies, patients who experienced an early hemoglobin response had statistically lower subsequent transfusion requirements, higher rates of subsequent hemoglobin response, shorter time to hemoglobin response, better improvements in quality of life scores, and lower average weekly epoetin alfa dose than patients who did not experience an early hemoglobin response. Similar proportions of patients experienced early response in the 3-times weekly and once-weekly epoetin alfa regimens. This ad hoc analysis found that early hemoglobin response to epoetin alfa therapy was associated with improved clinical benefits and drug utilization. Early hemoglobin response may therefore be considered as a desired goal of epoetin alfa therapies.

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Jeffrey A. Gilreath, David D. Stenehjem and George M. Rodgers

data surrounding adverse effects in patients with cancer when receiving other treatments for anemia, such as blood transfusions 11 and erythropoietic-stimulating agents (ESAs), 9 this article explores the risks and benefits of iron dextran TDI in

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Adrian Legaspi, Vanitha Vasudevan, Amit Sastry, Jeronimo Garcialopez de Llano and Marice Ruiz-Conejo

outliers with multiple comorbidities and prolonged LOS were excluded from the LOS calculation. Results: 51% were male (n=29) and 49% were female (n=28). The mean EBL was 62.5 ml with 7% (n=4) requiring a blood transfusion. Mean OR time (minutes): 238

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George M. Rodgers

10 g/dL, and patients being treated with chemotherapy with curative intent were excluded from ESA treatment. A retrospective study of patients with cancer receiving blood transfusions reported that red blood cell transfusions were associated with

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Mary Frances McMullin and Claire Harrison

first published guideline in 1984. The resultant library of documents includes guidelines on aspects of laboratory practice, from areas such as blood transfusion to highly complex clinical management. These guidelines are published in peer

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Peter L. Greenberg, Cynthia K. Rigsby, Richard M. Stone, H. Joachim Deeg, Steven D. Gore, Michael M. Millenson, Stephen D. Nimer, Margaret R. O'Donnell, Paul J. Shami and Rashmi Kumar

. 22 Chacko J Pennell DJ Tanner MA . Myocardial iron loading by magnetic resonance imaging T2* in good prognostic myelodysplastic syndrome patients on long-term blood transfusions . Br J Haematol 2007 ; 138 : 587 – 593 . 23 Di Tucci

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Daniel Shasha, Pierre Cremieux and Louis Harrison

): 302 – 306 . 13 Girinski T Pejovic-Lenfant MH Bourhis J . Prognostic value of hemoglobin concentrations and blood transfusions in advanced carcinoma of the cervix treated by radiation therapy: Results of a retrospective study of 386 patients

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Peter L. Greenberg, Leon E. Cosler, Salvatore A. Ferro and Gary H. Lyman

. 23. Cremieux PY Barrett B Anderson K Slavin MB . Cost of outpatient blood transfusion in cancer patients . J Clin Oncol 2000 ; 18 : 2755 – 2761 . 24. Shander A Hofmann A Gombotz H . Estimating the cost of blood: past, present, and