Article (Scientific journals)
Recombinant human erythropoietin therapy is very effective after an autologous peripheral blood stem cell transplant when started soon after engraftment.
Baron, Frédéric; Frere, Pascale; Fillet, Georges et al.
2003In Clinical Cancer Research, 9 (15), p. 5566-72
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Keywords :
Adolescent; Adult; Aged; Anemia/drug therapy/etiology; Blood Transfusion; Erythropoietin, Recombinant/therapeutic use; Female; Humans; Male; Middle Aged; Neoplasms/therapy; Stem Cell Transplantation/adverse effects; Time Factors; Transplantation, Autologous
Abstract :
[en] PURPOSE: Previous trials of recombinant human erythropoietin (rHuEpo) therapy after autologous hematopoietic stem cell transplantation have administered very high doses of i.v. rHuEpo starting on day 1 and continuing for 1-2 months until erythroid engraftment and have shown no benefit of rHuEpo therapy. We sought to establish a more effective use of rHuEpo in this setting. EXPERIMENTAL DESIGN: In this report, we show in a first cohort of 45 lymphoma or myeloma patients undergoing peripheral blood stem cell transplant (control group) that endogenous erythropoietin levels are high for the degree of anemia during the first 3 weeks after transplant but become adequate or slightly decreased thereafter. We thus enrolled 41 consecutive similar patients in a trial of rHuEpo therapy at a dose of 500 units/kg/week started on day 30 after the transplant. RESULTS: The 12-week probability of achieving hemoglobin (Hb) levels of 13 g/dl was 87% in rHuEpo-treated patients versus 14% in controls (P = 0.0001). Mean Hb levels were significantly higher in the rHuEpo group than in the control group from day 42 through day 150 after transplant (Ps of <0.05 to <0.001). Two of 41 patients in the rHuEpo group versus 12 of 45 patients in the control group had Hb levels of <9 g/dl between day 42 and day 100 after the transplant (P = 0.0078). CONCLUSIONS: Anemia after autologous peripheral blood stem cell transplant is exquisitely sensitive to rHuEpo when therapy is started soon after engraftment. This is the first convincing report showing that rHuEpo is effective in this setting. Our data set the stage for a more rational use of rHuEpo after autologous hematopoietic stem cell transplantation and should renew interest in erythropoietin therapy in this setting. Prospective, randomized trials should investigate the impact of rHuEpo therapy on transfusion requirements and quality of life.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Frere, Pascale ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Fillet, Georges ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Beguin, Yves  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Language :
English
Title :
Recombinant human erythropoietin therapy is very effective after an autologous peripheral blood stem cell transplant when started soon after engraftment.
Publication date :
2003
Journal title :
Clinical Cancer Research
ISSN :
1078-0432
eISSN :
1557-3265
Publisher :
American Association for Cancer Research, Inc. (AACR), Birmingham, United States - Alabama
Volume :
9
Issue :
15
Pages :
5566-72
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 March 2009

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