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Hematologic complications of malignancy: Anemia and bleeding

Reed E Drews, MD
Section Editor
Stanley L Schrier, MD
Deputy Editor
Jennifer S Tirnauer, MD


Anemia frequently complicates the course of cancer. While anemia may be a presenting sign of malignancy, it may also be a consequence of a patient's antineoplastic therapy or progressive disease. Since anemia is a frequent cause of fatigue and fatigue ranks as the most common symptom plaguing cancer patients and limiting their daily routines, recognizing anemia and its causes is important for identifying appropriate interventions that may improve the cancer patient's quality of life [1-5]. (See "Cancer-related fatigue: Prevalence, screening and clinical assessment", section on 'Anemia' and "Cancer-related fatigue: Treatment", section on 'Anemic patients'.)

This review will discuss those causes of anemia that are of specific relevance in patients with neoplastic disease. A general discussion of anemia and treatment of anemia in patients with malignancy is presented separately. (See "Approach to the adult patient with anemia" and "Anemia in adults due to decreased red blood cell production" and "Diagnosis of hemolytic anemia in the adult" and "Role of erythropoiesis-stimulating agents in the treatment of anemia in patients with cancer".)


Mechanisms — As with anemias in general, three broad categories should be considered when assessing causes of anemia in patients with malignancies. (See "Approach to the adult patient with anemia", section on 'Causes of anemia'.)

Red blood cell (RBC) losses from the body (blood loss anemia)

Increased RBC destruction (hemolytic anemia)

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Literature review current through: Nov 2017. | This topic last updated: Apr 30, 2017.
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