Recombinant human erythropoietin reduces the need for erythrocyte and platelet transfusions in pediatric patients with sarcoma: A randomized, double-blind, placebo-controlled trial

Porter, Joanne C.; Leahey, Ann; Polise, Karen; Bunin, Greta R.; Manno, Catherine S.

doi:10.1016/s0022-3476(96)70145-2

Cited by 64 publications

(52 citation statements)

References 17 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: 53%

“…This cutoff level was relatively higher in other studies, eg, 9 g/dL in one study 13 and 8 g/dL in another study. 8 We believe that the higher cutoff level may shadow the real difference between the erythropoietin-treated and the erythropoietin-untreated groups. The decrease of high erythropoietin levels to normal levels in the rHuEPO-treated group also could be attributable to both normalization of Hb levels (endogenous cause) and suppression of erythropoietin synthesis by rHuEPO (exogenous cause).…”

Section: Discussionmentioning

confidence: 97%

“…Most of the studies recommend rHuEPO treatment for 2 or 3 months in chemotherapy-induced anemia of solid tumors. Porter et al 8 mentioned that a starting dose of 150 IU/kg was administered to their pediatric patients with a median dose of 198 IU/kg rHuEPO per dose. They increased the rHuEPO dose if the patients had blood transfusions or inadequate response.…”

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: 53%

Section: Discussionmentioning

confidence: 97%

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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“…One study demonstrated decreased platelet transfusion requirements in the EPO-treated group. 27 This finding was not confirmed by any other group although platelet elevation has been reported in renal failure patients receiving EPO. 32 No direct measures of QOL have been made in any of the published pediatric trials.…”

Section: Epo In Pediatric Cancer Patientsmentioning

confidence: 76%

“…The mean EPO dose was 200 U/kg in one pediatric study that allowed for dose escalation titrated to response. 27 More recently, weekly dosing schedules have been tested and found to be as effective as TIW dosing at increasing Hb levels. 14,17 The weekly dosing schedule is 40,000 U SC q week or 600 U/kg SC q week.…”

Section: Epo Dosementioning

confidence: 99%