The anaemia of cancer: death by a thousand cuts

Nat Rev Cancer. 2005 Jul;5(7):543-55. doi: 10.1038/nrc1648.


Cancer has a negative systemic impact on its host in addition to its local or metastatic effects, and no cancer complication is more ubiquitous than anaemia, a condition for which there is now a specific remedy, the recombinant growth factor erythropoietin. This is not a trivial therapeutic consideration, because cancer-associated anaemia has an adverse influence on survival regardless of tumour type. However, the pharmacological correction of anaemia with recombinant erythropoietin could promote tumour growth, whereas the use of tumour-necrosis factor-alpha (TNFalpha) and TNF-related apoptosis-inducing ligand as antitumour agents could exacerbate anaemia, thereby perpetuating tissue hypoxia and tumour progression.

Publication types

  • Review

MeSH terms

  • Anemia / drug therapy
  • Anemia / etiology
  • Anemia / physiopathology*
  • Carcinogens / pharmacology
  • Cell Death / physiology
  • Erythropoiesis / drug effects
  • Erythropoiesis / physiology
  • Erythropoietin / pharmacology
  • Erythropoietin / physiology
  • Erythropoietin / therapeutic use
  • Humans
  • Hypoxia / physiopathology
  • Neoplasms / complications
  • Neoplasms / physiopathology*
  • Recombinant Proteins
  • Signal Transduction


  • Carcinogens
  • Recombinant Proteins
  • Erythropoietin