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Side Effect: Anemia

Anemia results when there are too few red blood cells to adequately deliver oxygen throughout the body. Anemia can be mild, moderate, or severe. If the red blood cell count drops too low, anemia can be life-threatening. Many treatment options for anemia exist. Watch our cancer and chemotherapy-induced anemia video to learn more about anemia and available treatments.

What is Anemia?

Anemia is a significant side effect seen with certain types of cancer therapy. It is defined as having less blood than normal. Anemia can be measured in several different ways using common laboratory markers that are provided by the complete blood count, or CBC. The most common lab tests used are the hemoglobin (Hb) and hematocrit (Hct).


What does anemia look like?

Laboratory markers of anemia:

Although the two measurements have different units, in most cases the hemoglobin (Hb) can be calculated by dividing the hematocrit by 3.

Clinical signs and symptoms of anemia, from head to toe, may include:


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Physical signs and symptoms resulting from anemia can be seen here. Because almost all body tissues need a continuous supply of oxygen, most cells and organs are affected when the body is anemic. Displayed here are a few organ symptoms that are affected by anemia and what a patient may experience if they become anemic.

Who gets anemia and when does it occur?

Anemia can develop as a result of 3 main causes leading to fewer red blood cells in the body. These include:

1) Low production of red blood cells by the bone marrow

2) Increased destruction of red blood cells (RBCs)

3) Loss of RBCs

Onset: Anemia can occur over weeks to months as a result of low RBC production due to the bone marrow-suppressing effects of chemotherapy. Or, anemia can happen quickly (over hours or days) resultng from RBC loss due to medications that increases the risk of bleeding.

How long does anemia last?

Depending upon what causes anemia, it may be short in duration if one is able to identify and correct all suspected contributing factors of anemia. However, if anemia is due to a disease or disorder that is not responding to treatment, the anemia may be long-term in duration.

How do you prevent anemia?

On occasion, cancer-and chemotherapy-induced anemia can be prevented by addressing risks for decreased RBC production, increased RBC destruction, and RBC loss. Strategies aimed at accomplishing this include, but are not limited to:

How do you treat anemia?

The treatment of anemia may include multiple modalities, and will likely depend upon the severity of anemia and the onset in which it appeared (in other words, how quickly did it develop?):

Anemia, immediate correction:

A packed RBC (pRBC) transfusion may be offered if there are signs or symptoms of organ damage or low oxygenation. One unit of pRBCs may take around 2 hours to transfuse. Likewise, two units of pRBCs may take around 4 hours to transfuse.

Anemia, non-immediate correction necessary:


1) Gilreath JA, Stenehjem DD, Rodgers GM. Diagnosis and treatment of cancer-related anemia. Am J Hematol. 2014;89:203-212.

2) Gilreath JA, Rodgers GM. How I treat cancer-associated anemia. Blood. 2020;136:801-813.

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Created: February 17, 2022 Updated: March 11, 2022