Our understanding of hematopoiesis and its regulation is
expanding rapidly, and the use of epoetin alpha, the recombinant form of
erythropoietin, has contributed to the clinical and social impact that
management of anemia may have in improving quality of life of patients with
hematologic malignancies, cancer, and HIV infection. We are also starting to
understand the potential therapeutic benefit of hemoglobin in patients receiving
radiation therapy, in HIV patients receiving antiviral therapy, and perhaps in
patients undergoing standard chemotherapy. Trials are now needed to clarify the
optimum hemoglobin level and the potential therapeutic impact of hemoglobin
maintenance. But the results obtained so far suggest that patients with mild
anemia should receive more attention by physicians and healthcare providers, to
minimize the clinical and social effects deriving from fatigue. Further research
into the broader field of the pathogenic mechanisms underlying fatigue syndromes
as well as design of new therapeutic interventions in cancer patients will be a
major priority for the years to come.
