Anemia associated with chemotherapy is a complicated condition in patients undergoing treatment for cancer. 

Chemotherapy drugs attack on fast-growing cells including cancer and healthy bone marrow cells. 

Less red blood cells or hemoglobin count reduces oxygen-carrying capacity of blood to cause anemia. 

Chemotherapy can affect kidney function to reduce the production of erythropoietin. The inflammatory response to cancer and its treatment can increase levels of cytokines. 

Patients with chemotherapy-associated anemia may experience symptoms as: 

Fatigue and weakness 

Shortness of breath 

Pale skin 

Rapid heartbeat 

Anemia is prevalent in cancer patients with 30% to 90% cases depends on cancer type and chemotherapy treatment. 

Chemotherapy-induced anemia is common in patients with hematologic malignancies and solid tumors.  

Chemotherapy treatment increases anemia risk from bone marrow suppression. Cancer patients experience anemia due to inflammation and infections. 

Chemotherapy affects stromal cells and extracellular matrix to damage the microenvironment of bone marrow. 

Cytokines decrease red blood cell production to inhibit progenitor cell growth. 

Chemotherapy enhances reactive oxygen species production that cause oxidative damage to RBCs. 

Tumors and chemotherapy may cause chronic blood loss and affect required vitamin absorption for DNA synthesis and RBC production. 

• Causes of anemia associated chemotherapy as: 
• Bone Marrow Suppression 
• Direct RBC Toxicity 
• Nephrotoxicity 
• Bone Marrow Infiltration 
• Chronic Inflammation 
• Radiation Therapy 

Elderly patients are at higher risk for severe anemia due to various factors. 

Poor nutrition and deficiencies in iron, vitamin B12, and folate damages anemia condition to affect recovery. 

Blood cancers in bone marrow increase risk of severe anemia. 

Advanced cancer equals higher tumor burden, inflammation, marrow suppression, severe anemia risks. 

Chemotherapy with myelosuppressive agents increases risk of anemia. 

It includes information about demography, medical history, family history, and presenting symptoms of patient. 

• Respiratory Examination 
• Cardiovascular Examination 
• Gastrointestinal Examination 
• Stool Examination 

Acute symptoms as: 

• Dyspnea 
• Chest Pain 
• Palpitations 
• Dizziness and Syncope 

Chronic symptoms as: 

• Fatigue 
• Weakness 
• Dyspnea 
• Pallor 

Use Erythropoiesis-Stimulating Agents in patients with chemotherapy-induced anemia those with chronic kidney disease or cancer-related anemia. 

Nutritional support and supplementation should be given in form of iron supplementation through various route. 

Management of chemotherapy to reduce dose intensity or frequency of myelosuppressive agents. 

Management of chronic diseases is conducted to optimize renal function and consider erythropoietin therapy. 

Red blood cell transfusions method is used to manage symptomatic anemia. 

Platelet transfusions are indicated to prevent bleeding in thrombocytopenia cases. 

Oncology, Radiation

Ensure safe environment to prevent falls and accidents in patients with weakness or dizziness. 

Balanced diet includes iron, B12, and folate supplementation to maintain adequate nutrition level. 

Use HEPA filters to reduce airborne particles and lower infection risk efficiently. 

Maintain ventilation in patient rooms for air quality control. Prepare food properly to prevent foodborne infections.  

Proper awareness about anemia associated chemotherapy should be provided and its related causes with management strategies. 

Appointments with an oncologist and preventing recurrence of disorder is an ongoing life-long effort. 

Oncology, Radiation

Epoetin: 

It is hormonal drug that stimulates red blood cell production. 

Oncology, Radiation

Ferric carboxymaltose: 

It is iron hydroxide in a complex with carboxymaltose that releases iron to transport oxygen. 

Oncology, Radiation

Blood transfusions method indicated to increase hemoglobin levels and severe symptoms of anemia. 

Bone marrow biopsy was performed to evaluate bone marrow function and eliminate bone marrow infiltration. 

Oncology, Radiation

In the initial assessment phase, evaluation of patient history, physical examination, and laboratory test to confirm diagnosis. 

Pharmacologic therapy is effective in the treatment phase as it includes use of Erythropoiesis-Stimulating Agents and iron supplementation. 

In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies. 

The regular follow-up visits with the oncologist are scheduled to check the improvement of patients along with treatment response.