ABSTRACT
Since anemia of chronic disease (ACD) is in most cases a secondary phenomenon driven by an activated immune response initiated by an underlying disease, the treatment of the underlying disease is thus the pivotal approach to treat ACD. However, a sufficient treatment of the underlying disease is not always possible, particulary in the case of patients with malignancies, chronic infections, or autoimmune disorders. Thus, specific therapeutic regimen are warranted that include the application of transfusions, iron, and=or human recombinant erythropoietin, all of which are very well reviewed in the following chapters. Importantly, the indications for the specific therapeutic regimen may vary with the underlying disease and can be completely different, for example, between patients with mammary carcinoma and those
with Crohn’s disease. Thus, it is mandatory to specifically choose the best available strategy for ACD therapy in respect to the underlying disease. Accordingly, little data are available on therapeutic endpoints in terms of finding the best hematocrit or hemoglobin level for ACD patients. An insufficient correction of anemia is associated with adverse effects toward the patient’s quality of life or cardiopulmonal performance (1,2), while over-correction of anemia may also harbor several problems such as thrombembolic complications. In ACD patients suffering from certain types of cancer, recent data suggest that over-correction of ACD may exert negative effects on the clinical course of the disease (3).
