Erythropoiesis-Stimulating Agents (ESAs)

Erythropoiesis-stimulating agents (ESAs) are intravenous or subcutaneous (injected under the skin) medications used to stimulate red blood cell production. ESAs are used for patients with anemia (low red blood cell numbers). ESAs are similar to erythropoietin proteins which are made naturally in the body to regulate the production of red blood cells. There are two FDA approved ESAs, Epoetin alfa (Procrit, Epogen) and Darbepoetin alfa (Aranesp).

ESAs can be used at varying doses in patients with MF (myelofibrosis) and/or other MPNs associated with low red blood cells (anemia). But ESAs don’t always work and aren’t always a good choice for anemic patients with MPNs. For this reason, it is important to discuss the potential risks and benefits of using ESAs with your physician to determine if this is medication is right for you.

Side Effects

Common side effects of ESA use can include: increased blood pressure, pain around the injection site, skin rash or redness, and decreased iron levels.

Rare side effects of ESA use can include: blood clots, allergic reactions, and red cell aplasia.

Richard T. Silver MD Myeloproliferative Neoplasms Center 520 E 70th Street Starr Pavillion, 341 New York, NY 10021 webengg@med.cornell.edu