Epoetin alfa administered prior to high-dose chemotherapy (HDCT) and autologous stem-cell rescue

Henry, Dave; Mason, Bridgett; Staddon, Arthur P.; Ford, Peggy; Matthews, Brian Edward

doi:10.1016/s0959-8049(99)81610-4

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“…Even partial response, defined on the basis of Hb rise obtained at the time of PBSCT after 1 month from rHuEPO administration, is sufficient to obtain these results, suggesting that treatment is worthwhile independently of immediate response evaluation. Similar results were obtained by Henry and colleagues [29] who treated 21 patients with solid tumors and lymphomas with rHuEPO starting 14 days before PBSCT, and the results were compared with nine matched previously treated patients who had not received EPO. Mean hemoglobin levels at the time of transplant were 12 g/d for patients treated with EPO and 9.7 g/d for the control group.…”

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confidence: 63%

Administration of recombinant human erythropoietin alpha before autologous stem cell transplantation reduces transfusion requirement in multiple myeloma patients

Martino

Olíva

Console

et al. 2004

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Recombinant human erythropoietin administered after peripheral blood stem cell transplantation (PBSCT) has been ineffective for the treatment of anemia. We administered recombinant human erythropoietin alpha (rHuEPO) prior to high-dose therapy after peripheral blood stem cell (PBSC) collection to evaluate its efficacy on transfusion requirements and hematological parameters during the post-transplant aplastic phase. Twenty-two multiple myeloma patients (EPO-MM) were included in the trial to receive rHuEPO 10,000 IU subcutaneous daily starting 30 days before PBSCT. Forty hemoglobin (Hb)-matched patients who had not received rHuEPO before transplant were retrospectively selected (Ctr-MM) for comparative data. None of the patients received transfusions at study entry. All but one patient responded to rHuEPO. However, no significant differences in Hb levels were obtained between the two groups at the time of transplantation. At nadir, the EPO-MM cases had a significantly higher Hb level (median 10 g/dl versus 7.6 g/d; p=0.001). Consequently, less than 20% of EPO-MM patients required packed red blood cell (PRBC) transfusions compared to more than half the Ctr-MM patients (p=0.007). Furthermore, the number of PRBC transfusions performed in the EPO-MM group was significantly lower (median 0 versus 1; p=0.008). Independently of Hb levels at PBSCT, rHuEPO therapy was significantly associated with a lower risk of transfusion requirement. In conclusion, rHuEPO is shown to be effective when administered prior to high-dose therapy in MM.

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Section: Discussionsupporting

confidence: 63%