Abstract: Objective 　To evaluate the effects of epoetin alfa ( EPO) therapy on hemoglobin ( Hb), transfusion requirements and quality of life (QOL) in patient s with cancer receiving chemotherapy. Methods 　 Seventy-nine patient s with Hb ≤12. 0g/ dL were randomized to receive EPO 8 000U three times per week s. c ( EPO group) or best supportive care (BSC group) for 8 weeks. Hemoglobin responses, transfusion requirements, QOL and toxicity were measured. Results 　EPO maintained Hb levels throughout the study with mean Hb levels ≥12. 0 g/ dL, compared with a decrease with BSC. Hemoglobin responses were 53. 8 %for EPO group, significantly higher than that in BSC group (7. 5 %) ( P < 0. 0001) . Transfusion requirement s in EPO patient s and BSC patients were 7. 7 % and 30 % (χ2 = 6. 388, P < 0. 05), respectively. At the eighth week, mean change score of FACT-An anemia and fatigue was (2. 16 ±12. 84), (3. 58 ±10. 52) for EPO group and ( - 4. 43 ±13. 42), ( - 5. 34 ±11. 14) for BSC group ( P < 0. 0001 for both comparisons) . Adverse event s were similar between the groups. Conclusion 　EPO maintains hemoglobin level, reduces t ransfusion requirements and improves QOL in patient s with cancer receiving chemotherapy.