Darbepoetin-alfa and intravenous iron administration after autologous hematopoietic stem cell transplantation : A prospective multicenter randomized trial
BEGUIN, Yves; Maertens, Johan; DE PRIJCK, Bernardet al.
2013 • In American Journal of Hematology, 88, p. 990-996
[en] We conducted a randomized study analyzing the impact of darbepoetin alfa (DA) administration with or without intravenous (i.v.) iron on erythroid recovery after autologous hematopoietic cell transplantation (HCT). Patients were randomized between no DA (Arm 1), DA 300 lg every 2 weeks starting on Day 28 after HCT (Arm 2), or DA plus i.v. iron 200 mg on Days 28, 42, and 56 (Arm 3). The proportion achieving complete hemoglobin (Hb) response within 18 weeks (primary end point) was 21% in Arm 1 (n524), 79% in Arm 2 (n525), and 100% in Arm 3 (n523; P < 0.0001). Erythropoietic response was shown to be significantly higher in Arm 3 (n546) than in Arm 2 (n550; P50.008), resulting in lower DA use, reduced drug costs, and improved quality of life scores, but the effect on transfusions was not significant. In multivariate analysis, DA administration (P< 0.0001), i.v. iron administration (P50.0010), high baseline Hb (P< 0.0001), and low baseline creatinine (P50.0458) were independently associated with faster achievement of complete Hb response. In conclusion, DA is highly effective to ensure full erythroid reconstitution after autologous HCT when started on Day 28 post-transplant. I.v. iron sucrose further improves erythroid recovery.
Disciplines :
Hematology
Author, co-author :
BEGUIN, Yves ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Maertens, Johan
DE PRIJCK, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Schots, Rik
Seidel, Laurence ; Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
BONNET, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
HAFRAOUI, Kaoutar ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
WILLEMS, Evelyne ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Vanstraelen, Gaetan
SERVAIS, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
JASPERS, Aurélie ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
FILLET, Georges ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
BARON, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Darbepoetin-alfa and intravenous iron administration after autologous hematopoietic stem cell transplantation : A prospective multicenter randomized trial
Publication date :
2013
Journal title :
American Journal of Hematology
ISSN :
0361-8609
eISSN :
1096-8652
Publisher :
Wiley Liss, Inc., New York, United States - New York
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