Reference : Recombinant human erythropoietin therapy is very effective after an autologous periphera...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/9392
Recombinant human erythropoietin therapy is very effective after an autologous peripheral blood stem cell transplant when started soon after engraftment.
English
Baron, Frédéric mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Frere, Pascale mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Fillet, Georges mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Beguin, Yves mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
2003
Clinical Cancer Research : An Official Journal of the American Association for Cancer Research
American Association for Cancer Research, Inc. (AACR)
9
15
5566-72
Yes (verified by ORBi)
International
1078-0432
Birmingham
AL
[en] 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
[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.
http://hdl.handle.net/2268/9392

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