Anemia in cancer patients: addressing a neglected issue - diagnostics and therapeutic algorithm

Cancer-related anemia (CRA) continues to be a critical concern despite advancements in oncology treatments. The prevalence of anemia varies from 30% to 90%, impacting the quality of life and prognosis of cancer patients. While CRA is often attributed to antineoplastic therapies, it can also result from the disease itself. Inflammation and the iron regulatory hormone hepcidin play significant roles in CRA pathogenesis. Treatment-induced anemia caused by chemotherapy, tyrosine kinase inhibitors (TKIs) and immunotherapy, pose additional challenges. Intravenous (IV) iron has emerged as an effective treatment option for CRA, overcoming limitations associated with oral iron supplementation. Combining IV iron and ESAs enhances treatment outcomes. Future directions involve exploring ESA safety and their immunomodulatory effects. Transfusions provide quick relief but might impact prognosis and immune response. Other considerations include incorporating physical activity and exploring hepcidin-directed therapy. In conclusion, CRA management necessitates a multifaceted approach to address deficiencies, optimize therapies and improve patient outcomes.