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To the Editor: The Contempo Update by Dr Maiese and colleagues¹ presents new avenues of exploration for erythropoietin. It provides evidence that would support the concept that erythropoietin, approved by the US Food and Drug Administration for the treatment of anemia associated with cancer chemotherapy, may not be appropriate for this indication. If erythropoietin is truly proangiogenic and antiapoptotic, as the authors suggest, the administration of this agent to patients with cancer would seem ill-advised. A recent report suggesting that erythropoietin may impair survival in patients with head and neck cancer² is further cause for concern for many oncologists who prescribe the drug rather routinely. Although erythropoietin may hold promise for the treatment of cardiovascular and cerebrovascular disease in the future, I believe that its current widespread use in patients with cancer is open to serious question.

Leonard Sadoff, MD
Happyon@aol.com
Department of Hematology/Oncology
Kaiser-Permanente
Los Angeles, Calif

1. Maiese K, Faqi L, Zhao CZ. New avenues of exploration for erythropoietin. JAMA. 2005;293:90-95. FREE FULL TEXT 2. Brower V. Erythropoietin may impair, not improve cancer survival. Nat Med. 2003;9:1439. FULL TEXT | ISI | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293:1858.

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