Concerns that signaling via the erythropoietin (EPO) receptor expressed on tumor cells may promote tumor progression have not been substantiated.125 The use of erythropoiesis-inducing agents may be appropriate to improve quality of life since tumor-promoting claims have not been substantiated.126 Anemia is usually not a reason to decrease the dose of, or to withhold, chemotherapy, but dose reduction should be considered usually if transfusions are required repeatedly. Here, EPO is linked to anemia (phenotype).