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Relationship Between Changes in Hemoglobin Level and Quality of Life During Chemotherapy in Anemic Cancer Patients Receiving Erythropoietin Therapy, they concluded that there was a direct relationship between the hemoglobin increases during Epoetin alfa therapy and corresponding quality of life improvements in cancer patients receiving chemotherapy across the clinically-relevant range of 8-14 grams per deciliter.

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The association of fatigue with the major cancer treatment modalities of surgery, chemotherapy, radiation therapy, and biologic response modifier therapy caused speculation that fatigue resulted from tissue damage or accumulation of the products of cell death.

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