Erythropoiesis after Therapy with Recombinant Human Erythropoietin: A Dose–Response Study in Anemic Cancer Surgery Patients

Abstract

Background and Objectives: Preoperative treatment with 600 U/kg of recombinant human erythropoietin (r–HuEPO) effectively increases erythropoiesis in cancer patients. The aim of this study was to evaluate the erythropoietic response after different doses of r–HuEPO in order to find the minimum effective dose. Materials and Methods: Twenty anemic sideropenic patients (hemoglobin ≤110 g/l; serum iron <600 μg/l) with cancer of the gastrointestinal tract were randomly allocated to two groups: the first (n = 10) received 400 U/kg of r–Hu EPO divided in 4 doses (100 U/kg each, every 4 days); the second (n = 10) received 200 U/kg of r–HuEPO (50 U/kg each, every 4 days). Both groups were given intravenous iron gluconate (125 mg) every day for 15 days. Results: After treatment, the serum iron level significantly rose in both groups. The production of new red blood cells was 176.3±90.8 ml in the 200 U/kg group and 268.4±79.4 ml in the 400 U/kg group (p = 0.036). The increase of hemoglobin was significantly higher in the 400 U/kg group (22.3±2.0 g/l) than in the 200 U/kg group (14.1±2.7 g/l) (p = 0.017). Conclusion: The r–HuEPO dose of 400 U/kg appears significantly more effective than the 200 U/kg to stimulate erythropoiesis in anemic sideropenic cancer patients.