Erythropoietin Treatment of Anemia Associated with Multiple Myeloma

Abstract

Anemia is a common complication of multiple myeloma. It resolves early in the disease if chemotherapy induces a complete remission, but persists if the disease progresses, causing disabling symptoms and often requiring blood transfusions. We treated 13 patients with myeloma-associated anemia by administering recombinant human erythropoietin three times a week for six months. Eleven patients (85 percent) had steady increases in hemoglobin levels and eventual correction of the anemia. Their symptoms of anemia subsided, and they reported a heightened sense of well-being. No patient had any adverse side effects, particularly episodes of hypertension. Monitoring of the serum M component showed a predominantly stable tumor load without apparent interaction between the underlying disease and the response to erythropoietin therapy. The number of erythroid burst-forming units in the bone marrow and peripheral blood and the level of erythropoiesis in bone marrow smears increased significantly during therapy. Pretreatment serum levels of erythropoietin were higher in the patients who did not respond and in those who required more than two months of treatment before they responded. Serum iron, ferritin, and transferrin concentrations reflected responses to treatment. We conclude that recombinant human erythropoietin is a promising therapeutic tool for treating myeloma-associated anemia.

Epoetin alpha prevents anaemia and reduces transfusion requirements in patients undergoing primarily platinum-based chemotherapy for small cell lung cancer

“…Again, any differences between groups may have been masked by the administration of blood transfusions or the effects of repeated chemotherapy. In common with previously published findings (Ludwig et al, 1990;Abels, 1993), treatment with both dosages of epoetin α showed excellent tolerability throughout the study. The incidence and type of adverse events did not differ markedly between the three groups, and epoetin α had no effect on the rate of premature study discontinuation.…”

“…Several studies in anaemic chemotherapy-treated patients have shown increased haemoglobin (Hb) levels and decreased red blood cell (RBC) transfusion requirements following treatment with Epoetin alpha prevents anaemia and reduces transfusion requirements in patients undergoing primarily platinum-based chemotherapy for small cell lung cancer epoetin α in patients with a variety of malignant diseases; moreover, epoetin α was well-tolerated (Henry et al, 1989;Ludwig et al, 1990Ludwig et al, , 1993aLudwig et al, , 1993bAbels, 1993;Cascinu et al, 1993;Case et al, 1993). More recently a non-randomized phase IV study with data available on 2030 patients was reported.…”

The cost-effectiveness of treatment with erythropoietin compared to red blood cell transfusions for patients with chemotherapy induced anaemia: A Markov model

“…The costs and effects of EPO treatment in different patient groups have been widely discussed since the early 1990s [5,7]. In a study by Remák et al [8], the change in cost-effectiveness of epoetin alfa treatment versus RBCTs for patients with renal failure in the UK between the years 1990 and 2000 was analysed.…”

Patients Previously Transfused or Treated with Epoetin Alfa at Low Baseline Hemoglobin Are at Higher Risk for Subsequent Transfusion: An Integrated Analysis of the Canadian Experience

“…It was the development of a human recombinant erythropoietin in 1983 [8] that allowed for the first innovative and effective treatment alternative for cancer-related anemia. A consistent body of evidence has since emerged, confirmed in numerous clinical trials, that treatment with erythropoietic agents in patients with anemia related to cancer and/or cancer treatment significantly decreases RBC transfusion requirements and increases hemoglobin (Hb) levels [9][10][11][12][13][14][15][16][17][18][19][20][21][22]. More recently, improved quality of life (QOL) associated with the use of erythropoietic agents has also been confirmed in cancer patients [10-15, 23, 24].…”