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The findings "show that erythropoiesis-stimulating agents increase mortality in all patients with cancer, and a similar increase might exist in patients on chemotherapy," the authors wrote. "In clinical practice, the increased risks of death and thromboembolic events should be balanced against the benefits of treatment with erythropoiesis-stimulating agents, taking into account each patient's clinical circumstances and preferences. More data are needed for the effect of these drugs on quality of life and tumor progression, and meta-analyses similar to this one will address these questions," they added.

Dr. Charles Bennett, the A.C. Beuhler professor of geriatric medicine at the Feinberg School of Medicine at Northwestern University, helped conduct a study, published in the Journal of the American Medical Association early last year, that also found similar risks for the use of ESAs by cancer patients. He believes the new data support those findings.

"The message is clear: There is a safety concern that's real and significant," Bennett said.

In addition, Bennett believes that quality-of-life issues and the need for a reduction in blood transfusions for cancer patients are overstated. "The [appropriate] use of these drugs in the United States is for palliative care in cancer patients and I support that," he said.

More information

For more information on ESAs, visit the U.S. Food and Drug Administration.

SOURCES: Scott Klarenbach, M.D., assistant professor, University of Alberta, AHFMR Population Health Investigator, Edmonton, Canada; Anthony Reiman, M.D., University of Alberta, Edmonton, Canada; Charles Bennett, M.D., Ph.D., A.C. Beuhler professor of geriatric medicine, Feinberg School of Medicine, Northwestern University, Chicago; May 2, 2009, The Lancet; Apri
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