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ESAs (marketed as Procrit, Epogen and Aranesp) stimulate the bone marrow to produce more red blood cells but are associated with shorter survival and increased risk of blood clots and tumor progression, the guidelines noted.
ESAs should not be given to cancer patients who are not receiving chemotherapy, except for those with myelodysplastic syndrome (MDS).
Doctors should discuss individual risks and benefits of ESAs and blood transfusion with patients before therapy. This shared decision-making is critical.