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Epoetin alfa appears to be useful in a range of nonrenal indications, where it is either an effective alternative to blood transfusion or a means of improving patient quality of life. It appears to be particularly useful in patients with anaemia associated with administration of drugs such as zidovudine and antineoplastics.However, disappointing results have been obtained among patients receiving epoetin alfa to facilitate autologous blood donation prior to elective surgery. Several trials have not reported any reduction in allogeneic blood transfusion requirements in epoetin alfa recipients.The drug is well tolerated in nonrenal applications. Adverse effects have been no more frequent among epoetin alfa recipients than placebo recipients in several trials.Although epoetin alfa is not generally cost saving compared with blood transfusion or no treatment, its value lies in improving quality of life, the avoidance of transfusion-related complications and the conservation of a scarce resource.