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ESA APPRISE Oncology Program Patient and Healthcare Provider Acknowledgment Form (Acknowledgment Form) ( alfa), ( alfa), and ( alfa) are Erythropoiesis.

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ESA, erythropoiesis-stimulating agent; HgB, hemoglobin; N/A, not applicable; Q3W, every 3 weeks; SC, subcutaneously; TIW, three times per week. * Including alfa-epbx. † Initiate only if HgB is < 10 g/dL and there is a minimum of two additional months of planned chemotherapy.

Erythropoietin stimulating agents (ESAs) are recombinant versions of EPO produced pharmacologically. Examples of ESAs are , , and methoxy polyethylene glycol- beta. ESAs are generally indicated in conditions where there is impaired red blood cell production.

ESAs may shorten overall survival and/or increase the risk of tumour progression or recurrence, as shown in clinical trials in patients with breast, head and neck, lymphoid, cervical, non-small cell lung cancers and patients with active malignancies who are not treated with either chemotherapy or radiotherapy.

The ESA APPRISE Oncology program requires that all healthcare professionals who prescribe ESAs for patients with cancer do the following: Complete a training module that covers the use of ESAs. Completion of the training module is required for enrollment in the ESA APPRISE Oncology program.

ESA APPRISE was a risk evaluation and mitigation strategy (REMS) program created to ensure that the benefits outweighed the risks when ESAs are used to minimize red blood cell transfusions in patients with cancer and chemotherapy-induced anemia.

The ESA APPRISE Oncology program requires that all healthcare professionals who prescribe ESAs for patients with cancer do the following: Complete a training module that covers the use of ESAs. Completion of the training module is required for enrollment in the ESA APPRISE Oncology program.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232