Cisplatin-associated anaemia treated with subcutaneous erythropoietin. A pilot study

Cascinu, Stefano; Fedeli, Anna; Fedeli, S. Luzi; Catalano, Giuseppina

doi:10.1038/bjc.1993.27

Cited by 25 publications

(17 citation statements)

References 13 publications

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“…Deep vein thrombosis, flushing, polycytemia, and high blood pressure are among the reported complications. 5,7,8,12 We did not observe any of these complications.…”

Section: Discussionmentioning

confidence: 54%

“…Most of rHuEPO studies are related with adult cases. 2,[5][6][7]11,12 Firstly, Miller and coworkers 5 mentioned that adult patients who had received high rHuEPO doses (100 -200 IU/ kg) showed a good response. Dunphy et al 6 reported that the rHuEPO dose should be increased in patients who used paclitaxel and carboplatin if the response was inadequate with 150 IU/kg.…”

Section: Discussionmentioning

confidence: 99%

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Recombinant Human Erythropoietin Treatment for Chemotherapy-related Anemia in Children

et al. 1999

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ABSTRACT. Objective. The efficacy and safety of recombinant human erythropoietin (rHuEPO) treatment in chemotherapy-induced anemia in children were investigated. rHuEPO is used to treat chemotherapy-induced anemia. Several studies recommend 150 to 300 IU/kg rHuEPO for 2 to 8 months. There are only a few controlled trials in children and no precise data about the optimal dose and duration of rHuEPO treatment is available.Patients and Methods. Thirty-four patients receiving chemotherapy for treatment of their solid tumors between October 1996 and June 1997 were included in this study. Patients were randomly selected for each group. The male/female ratio was 20/14, and the median age was 5 years (range, 1-16 years). They had normal hemoglobin levels at the time of diagnosis. When hemoglobin levels decreased to levels lower than 10 g/dL, rHuEPO (150 IU/kg/d, 3 times a week, subcutaneously) was given to 17 patients for 2 months. Their renal, liver, and pulmonary functions were normal. None of the patients had hematologic disease. We did not use any other drugs such as iron or granulocyte colony-stimulating factor. There were 17 patients in the control group. Fifteen patients got chemotherapy regimens including cisplatin (CDDP), but 19 were treated with regimens without CDDP. At the end of rHuEPO treatment, all patients were examined in terms of transfusion requirements and rate of change in hemoglobin levels.Results. One patient in the study group needed a blood transfusion, whereas 8 patients needed a transfusion in the control group. Patients in the study group had less transfusion requirements compared with the control group. The mean hemoglobin levels before and after the study were 8.48 ؎ 0.98 g/dL and 8.41 ؎ 1.65 g/dL in the control group and 8.50 ؎ 0.85 g/dL and 10.21 ؎ 2.14 g/dL in the rHuEPO group, respectively. Optimal hemoglobin increments began in 4 weeks and continued during treatment. CDDP-receiving and CDDP-nonreceiving groups did not have any difference in pretreatment serum erythropoietin levels. rHuEPO treatment was more effective in patients treated with non-CDDP regimens. Mean hemoglobin level increased from 8.68 ؎ 0.73 g/dL to 10.26 ؎ 1.84 g/dL in 9 patients treated with non-CDDP chemotherapy regimens in the erythropoietin group, although it increased from 8.28 ؎ 0.97 g/dL to 10.15 ؎ 2.5 g/dL in 8 patients treated with CDDP-containing regimens in the erythropoietin group. rHuEPO caused high blood pressure in only 1 patient that resolved spontaneously after cessation of erythropoietin treatment for a week.Conclusion. rHuEPO treatment (150 IU/kg/d 3 times a week) is effective and safe in children with chemotherapy-induced anemia. It decreases blood transfusion requirements in solid tumor patients. Our results show that the response to rHuEPO in CDDP-induced anemia is less than the response in non-CDDP receiving patients. Higher doses may be necessary in patients using CDDP. Pediatrics 1999;103(2). URL: http://www.pediatrics.org/ cgi/content/full/103/2/e16; erythropoietin, solid tumors, chemotherapy...

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“…Deep vein thrombosis, flushing, polycytemia, and high blood pressure are among the reported complications. 5,7,8,12 We did not observe any of these complications.…”

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Recombinant Human Erythropoietin Treatment for Chemotherapy-related Anemia in Children

et al. 1999

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“…rh-EPO can be effective in ameliorating chemothera py-induced anemia [9,10]. In a large study of patients receiving cyclic combination chemotherapy in a prospec tive multicentre, double-blind, placebo-controlled trial, the increase in haematocrit (Hct) in the rh-EPO-treated group compared with Hct in the placebo-treated group was statistically significant (p = 0.0001) [11], These au thors found that the baseline S-EPO levels were not asso ciated with responsiveness to rh-EPO therapy in this patient population.…”

Section: Introductionmentioning

confidence: 99%

Recombinant Human Erythropoietin in the Treatment of Cancer-Related Anaemia

Falkson

Keren-Rosenberg²,

Uys³

et al. 1994

Oncology

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The aim of this study was to investigate the effects of recombinant human erythropoietin (rh-EPO) in patients with cancer-related anaemia. Thirty-six ambulatory patients who had malignant neoplasms and haemoglobin (Hb) values of < 11 g/dl (Pretoria is 1,310 m above sea level) entered the study. Patients with renal insufficiency, or anaemia caused by bleeding or haemolysis, and patients with iron deficiency or megaloblastic anaemia, were not entered in the study. 22 IU/kg rh-EPO was given subcutaneously 3 times/ week. The dose was escalated if Hb values did not rise after 4 weeks. All 36 patients were evaluable for toxicity. Side effects ascribed to rh-EPO were pain or discomfort at the site of injection (12 patients), heart palpitations (3 patients), skin rash (2 patients) and hypertension, deep vein thrombosis, and myalgia in 1 patient each. Thirty of the 36 patients who entered the study were evaluable for response. There were 16 females and 14 males among the evaluable patients. Median age was 64.5 years. Response, defined as an increase of Hb of at least 2 g/dl or to 12.5 g/dl, for at least 1 month, was documented in 12 patients. This was accompanied by an improvement in performance status and occurred within 1 month in 5 of the 12 patients who responded. rh-EPO has a limited but measurable therapeutic value for patients with cancer-associated anaemia.

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“…9,10 Three reports have shown improved anemia, reduced transfusions, and a dose response after the addition of exogenous EPO to cisplatin-based combination chemotherapy. 10,11,12 Trials using single agent paclitaxel have reported conflicting results with regard to whether anemia is a major side effect. In none of these trials was EPO administered.…”

Section: Discussionmentioning

confidence: 99%