Anemia of malignancy.

Anemia is a common association of malignant disease. It may be the first diagnostic clue to an underlying malignant disease, it may contribute to the patient's symptoms from the disease, and it may affect treatment decisions. It is important to recognize that a number of underlying mechanisms may contribute to the anemia, and to exclude those that are treatable. The recognition that tumor-associated cytokine production is a major factor in the anemia of malignancy, and that recombinant EPO can overcome this suppression, are major steps forward.