A Single Institutional Experience: Is Epoetin Alpha Effective in Anemic Children with Cancer?

Abstract

The authors aimed to investigate the efficacy of epoetin-alpha on hemoglobin levels and red cell transfusion requirement in children with both hematologic malignancy (HM, n = 27) and solid tumors (ST, n = 14). Epoetin-alpha was given (150 U/kg or 250 U/kg, thrice weekly) for 12 weeks. Epoetin alpha significantly increased the hemoglobin levels at the 2nd and 3rd months of therapy (p <.05). At the 3rd month, the patients required less red cell transfusion. At the dose of 150 U/kg, only three patients with HM, but none of the ST patients, required red cell. However, none required red cell transfusion after 2nd month on epoetin alpha 250 U/kg. Epoetin-alpha administration increases hemoglobin levels and decreases red cell transfusion requirement in children with malignancy.

RECOMBINANT HUMAN ERYTHROPOIETIN BETA THERAPY: An Effective Strategy to Reduce Transfusion Requirement in Children Receiving Anticancer Treatment

“…Whereas most authors favor 11 g/dL, which is the set point of anemia determined by World Health Organization, the values recommended by the others vary between 9 and 12 g/dL [3,10,13,15,[18][19][20]. Recently, an Hb concentration of ≤11.9 g/dL has been proposed for commencement of therapy because of the satisfactory hematologic response, decreased RBC transfusion requirement and significant positive effects on QoL [20,28].…”

“…Twenty-seven and 30% of the patients received RT in the study and control groups, respectively. All patients were followed for 15.16 ± 4.98 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) weeks. The durations of follow-up for epoetin and control groups were similar (16.04 ± 4.78 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and 14.70 ± 4.53 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] weeks, res...…”

“…Although there are numerous valuable studies assessing the effectiveness of epoetin alfa in children with cancer, there are not as many studies with epoetin beta (Table 3) [10,[12][13][14][15][16][17][18][19]25]. Only two studies have been carried out with epoetin beta in children with thalassemia and in renal transplant recipients [26,27].…”

“…Minimum, maximum, and mean Hb concentrations and the time of the maximum and minimum Hb concentrations in the treatment period were determined. A hemoglobin concentration less than 7 g/dL was taken as the indication for RBC transfusion [10,13,15,17,19]. No patient was given iron supplementation, which might alter Hb levels.…”

“…The response rate in adults, as measured by elevation of hemoglobin and diminution of RBC transfusion requirements, ranges from 21 to 85% [6][7][8]. To date, some important studies have examined the role of rHuEPO in children with cancer by utilizing epoetin alfa [10][11][12][13][14][15][16][17][18][19]. In our prospective and historical controlled study, epoetin beta was used to find out the effect of rHuEPO on hemoglobin (Hb) concentrations and RBC transfusion requirement in children receiving CT ± radiotherapy (RT).…”