Erythropoiesis-Stimulating Agents (ESAs)

ESAs are used to increase the production of red blood cells. Having more red blood cells will treat the anemia caused by your chemotherapy treatment by increasing the amount of hemoglobin in your body.

ESAs such as EPREX® and Aranesp® are proteins made in the laboratory that act like a substance naturally made in the human body called erythropoietin. Erythropoietin controls the body’s production of red blood cells. Like erythropoietin, ESAs travel through the body to the bone marrow where they initiate the production of more red blood cells.

ESAs are used to treat chemotherapy-related anemia in non-myeloid malignancies where anemia is due to the effects of concomitantly administered chemotherapy. They are not given to replace any treatment you are receiving for your cancer. In patients receiving radiotherapy alone, ESAs are not appropriate.

Patients with uncontrolled hypertension should not be treated with ESAs; blood pressure should be controlled adequately before initiation of therapy. ESAs should be used with caution in patients with a history of seizures. Antibody-mediated pure red cell aplasia (PRCA) has been reported after months to years of treatment with ESAs.

If you are a cancer patient and your hemoglobin is kept too high (over 120 g/L) your tumor may grow faster; and you have an increased chance of heart attack, stroke, blood clots and death.

Your doctor should use the lowest dose of ESA needed to avoid red blood cell transfusions. In some instances, red blood cell transfusion should be the preferred treatment option. Once you have finished your chemotherapy course, the ESA should be discontinued.

Read Taking Action to help you determine if the cost of your medication will be covered.