A phase II study of up-front red blood cell transfusion before chemotherapy followed by maintenance Erythropoetin-alpha subcutaneous support during chemotherapy of anaemic breast-, colorectal- and ovarian cancer patients

Study hypothesis: An upfront Red Blood Cell Transfusion (RBCT) aiming at low-normal Haemoglobin (Hb) levels will ameliorate anemia-caused tumour hypoxia-related resistance to chemotherapy before the start of chemotherapy and may decrease secondary anemia-induced endogenous release of cytokines like Vascular Endothelial Growth Factor (VEGF), osteopontin. The maintenance of optimal Hb levels at this lower-normal range during chemotherapy by weekly maintenance administration of Erythropoetin-alpha (Epo-alpha) subcutaneous (s.c.) at doses with proven safety and efficacy creates optimal conditions for tumour oxygenation, without the presumably high-Hb level associated adverse effects.
Primary outcome(s): 1. Hb levels before the start of and during chemotherapy
2. Safety of the pCATS anaemia treatment regimen