Darbepoetin Alfa With or Without Iron in Treating Anemia Caused By Chemotherapy in Patients With Cancer

DISEASE CHARACTERISTICS:

* Diagnosis of a non-myeloid cancer (other than non-melanomatous skin cancer)
* Receiving or scheduled to receive chemotherapy (biological agents, such as small molecules/tyrosine kinase inhibitors and antibody-based therapies, are allowed)
* Has chemotherapy-related anemia (hemoglobin \< 11 g/dL)

  * No anemia known to be secondary to gastrointestinal bleeding or hemolysis
  * No anemia known to be secondary to vitamin B12 or folic acid deficiency

    \+ Vitamin B12 and folic acid deficiency must be ruled out if the mean corpuscular volume (MCV) is \> 100 fL
  * No anemia secondary to chemotherapy-induced myelodysplastic syndromes
* No primary hematologic disorder causing moderate to severe anemia (e.g., congenital dyserythropoietic anemia, homozygous hemoglobin S disease or compound heterozygous sickling states, or thalassemia major)

  \- Carriers for these disease states are eligible
* No first-degree relative with primary hemochromatosis (unless the patient has undergone HFE genotyping and was found to have at least one wild-type allele, while the proband in the family demonstrated to have either the common C282Y or H63D mutation)

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Ferritin \> 20 mcg/L (i.e., not obviously iron deficient)
* ALT or AST \< 5 times upper limit of normal
* Alert, mentally competent, and able to sign informed consent
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for 3 months after completion of study treatment
* Willing or able to be randomized and undergo study treatment
* Willing or able to fill out quality-of-life forms
* No uncontrolled hypertension (i.e., systolic blood pressure \[BP\] ≥ 180 mm Hg or diastolic BP ≥ 100 mm Hg)
* No history of uncontrolled cardiac arrhythmias
* No pulmonary embolism or deep venous thrombosis within the past year (unless the patient is on anticoagulation therapy and planning to continue it during study participation)
* No known hypersensitivity to darbepoetin alfa, erythropoietin, mammalian cell-derived products, iron, or human albumin
* No seizures within the past 3 months
* No gastrointestinal conditions expected to cause significant impairment of oral iron, such as untreated celiac disease or amyloidosis involving the gut - Patients with celiac disease who are adhering to a gluten-free diet are eligible

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* More than 3 months since prior darbepoetin alfa, epoetin alfa, or any investigational forms of erythropoietin (e.g., gene-activated erythropoietin or novel erythropoiesis-stimulating protein)
* More than 1 year since prior peripheral blood stem cell or bone marrow transplantation
* More than 2 weeks since prior red blood cell transfusions
* More than 14 days since prior major surgery
* No prior gastrectomy or resection of \> 100 cm of small intestine
* Not planning to undergo stem cell or bone marrow transplantation within the next 6 months