Erythropoietic agents in the management of cancer patients. Part 2: studies on their role in neuroprotection and neurotherapy.

Cognitive dysfunction has been reported in subsets of cancer patients and has been related to their underlying disease (small-cell lung cancer [SCLC]) or to a specific therapy (prophylactic cranial irradiation in SCLC, chemotherapy in breast cancer). Patients with uremic encephalopathy who have had their hemoglobin levels normalized by erythropoietic therapy have shown improved cognitive function in some studies. The mechanism responsible for the improvement is unknown and might reflect either a direct neuroprotective effect of erythropoietins on the central nervous system or the benefit of increased tissue oxygenation secondary to the correction of peripheral anemia. Whether erythropoietic agents can affect the cognitive dysfunction reported among some cancer patients is currently being investigated. The current state of knowledge about the use of erythropoietic agents for neuroprotection or the treatment of neurologic syndromes is described.