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What is Anaemia?
Anaemia is a general term referring to a shortage of red blood
cells or a reduction in their haemoglobin content. Haemoglobin is
the pigment in the blood that carries oxygen in the red blood
cells. A shortage of these red blood cells means that the blood is
unable to carry adequate amounts of oxygen to all parts of the
body. The subsequent reduction in oxygen in the tissues can cause
severe damage.
Anaemia in cancer
Anaemia has been reported to affect over 50 percent of cancer
patients. Numerous factors are involved, the most significant of
which are shortened red blood cell life span, blood loss and
suppression of production of red blood cells.
In addition to fatigue, many of the other consequences of
cancer-related anaemia, namely cardiovascular, gastrointestinal
and vascular symptoms, can adversely affect the quality of life of
patients and possibly alter their response to cancer treatment.
Studies have shown that the symptoms of cancer-related anaemia are
exacerbated by commonly used cancer treatments, particularly
platinum-based chemotherapy.
Management of anaemia in cancer
Anaemia in cancer used to be left largely untreated and was
regarded by many physicians as a minor aspect of the disease and
associated therapy. Nowadays, however, recognition of the severity
of the negative impact of anaemia on quality of life, through
fatigue, depression, nausea and the inability of patients to work
or fulfil their social roles, has led to anaemia management
becoming an integral part of quality treatment for cancer
patients.
Previously, blood transfusions were the mainstay of treatment for
cancer-related anaemia. However, approximately 20 percent of blood
transfusions are associated with adverse reactions, some of which
may be severe and/or life threatening. Nowadays recombinant human
erythropoietin (rh-EPO) is used to treat anaemia. Erythropoietin
acts by stimulating the production of red blood cells and
prolonging their survival.
Anaemia in chronic renal disease (renal
anaemia)
Anaemia is extremely common in chronic renal disease (CRD),
affecting up to 90 percent of patients. Renal anaemia is found not
only in patients with end stage renal disease (ESRD) receiving
dialysis treatment, but also in patients who are not yet on
dialysis. One of the most obvious consequences of renal anaemia is
impaired function of the heart and blood vessels (cardiovascular
dysfunction).
Management of renal anaemia
The extent of the devastating consequences of renal anaemia was
not fully revealed until the development of recombinant human
erythropoietin (rh-EPO). Following treatment with rh-EPO, patients
showed improvements in many areas, including physical performance,
contractility of skeletal muscle and overall well being. Nowadays,
rh-EPO together with iron therapy is a standard treatment for
hemodialysis patients with renal anaemia. However, treating renal
anaemia in patients not yet receiving dialysis is extremely
important in order to avoid cardiovascular dysfunction in the long
term.
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