Abstract Treatment of anaemia is a very important aspect in the management of cancer patients. In order to carry out a consensus process about the use of erythropoietic stimulating agents (ESAs) in cancer patients, the Spanish Society of Medical Oncology (SEOM) elaborated a work- ing group which coordinated a panel of medical oncology specialists. This working group has reviewed the main is- sues about the use of ESAs. In addition a consensus meet- ing was held in Madrid on 25 April 2007. The following conclusions were made: Since ESA treatment increases the haemoglobin (Hb) level and decreases the red blood cell (RBC) transfusion requirements, ESAs should be used within the approved indications in patients undergoing che- motherapy treatment, beginning at a Hb level below 11 g/ dl and maintaining it around 12 g/dl, with iron supplements if necessary. Neither increasing the ESA dose in non- responders nor the use of ESAs in the treatment of chronic cancer-related anaemia is recommended. Keywords Cancer-associated anaemia · Erythropoietic stimulating agents · Chemotherapy · Consensus · Update Introduction Anaemia is a frequent haematological complication in cancer patients. Its aetiology is multifactorial and it is per- ceived more intensely than other symptoms such as pain or nausea [1]. It can be due to cancer itself (it is estimated that it affects 40% of patients at the time of cancer diagnosis) [1] or to the chemotherapy or radiotherapy treatments (it affects 75% of the patients undergoing one or both treat- ments) [2]. However, only 40% of patients receive a spe- cific treatment for anaemia [1]. Treatment of anaemia is a very important aspect in the management of cancer patients as its presence is directly re- lated to a detrimental effect on the quality of life (QOL) [3]. There are two therapeutic options currently available for the management of cancer-associated anaemia: red blood cell (RBC) transfusion and the use of erythropoietic stimulating agents (ESAs). RBC transfusion is the oldest and classical method, and it is still used whenever an immediate increase of Hb levels is required. However, RBC transfusion can un- dergo side effects or complications such as haemolytic reac- tion or transmission of infectious diseases. Thus, the use of *Supported by an unrestricted educational grant from MSD Oncology The affiliations are listed at the end of the article V. Alberola Candel () Servicio de Oncología Médica, 6.ª planta Hospital Arnau de Vilanova C/ San Clemente, 12 ES-46015 Valencia, Spain e-mail: alberola_vicara@gva.es Clin Transl Oncol (2009) 11:727-736 DOI 10.1007/s12094-009-0435-6 EDUCATIONAL SERIES Yellow Series* Spanish Society of Medical Oncology consensus on the use of erythropoietic stimulating agents in anaemic cancer patients Vicente Alberola Candel · Alfredo Carrato Mena · Eduardo Díaz-Rubio García · Pere Gascón Vilaplana · Manuel González Barón · Miguel Martín Jiménez · Emilio Alba Conejo · Javier Cassinello Espinosa · Ramon Colomer · Juan Jesús Cruz Hernández · Agustí Barnadas i Molins · Carlos Camps Herrero · Ana M.ª Casas Fernández de Tejerina · Joan Carulla Torrent · Manuel Constenla Figueiras · Joaquin Gavilá Gregori · M.ª Dolores Isla Casado · Bartomeu Massuti Sureda · Mariano Provencio Pulla · César Augusto Rodríguez Sánchez · Jaime Sanz Ortiz on behalf of the Spanish Society of Medical Oncology (SEOM) Received: 5 April 2009 / Accepted: 14 May 2009 ADVANCES IN CLINICAL MANAGEMENT AND THERAPY OF CANCER