The impact of weekly dosing of epoetin alfa on the haematological parameters and on the quality of life of anaemic cancer patients

Abstract

The aim of this study was to evaluate the effectiveness and the impact of once-weekly administration of epoetin alfa (Ea) on the management of anaemia and on the quality of life (QOL) of cancer patients receiving chemotherapy. Eighty cancer patients with life expectancy > or = 24 weeks and haemoglobin (Hb) levels < 10.5 g/dL were studied. After an initial screening of patients' demographic and clinical characteristics, Ea 40000 U once a week was administered over a period of 4 months. In case of patients with Hb level exceeding > 14 g/dL or in case of non-response, the dosage was reconsidered. Every month, data regarding Hb levels, clinical variations, changes in the chemotherapy regimen and transfusion use since the last study visit, were evaluated. The Linear Analogue Scale Assessment scale was used for the evaluation of the QOL. The readmissions to hospital rates (P < 0.002) and the transfusion use rates (P < 0.003) were significantly decreased comparatively with baseline. A mean increase from baseline to the final Hb level (P < 0.001) was established, as well as a significant improvement in the functional ability, energy and in the overall QOL (P < 0.001). In conclusion, the treatment of cancer patients with Ea once-weekly is effective and safe, improving their haematological parameters and QOL.

Internal environment in cancer patients and proposal that carcinogenesis is adaptive response of glycolysis to overcome adverse internal conditions

“…* p < 0.05, ** p < 0.01. lymphocytopenia, were also present. Although clinicians are empirically aware of the deteriorated conditions such as hypoxia, immunosuppression and anemia in cancer patients [13][14][15][16][17][18][19][20], as shown by a review of the literature, few studies have been done on the simultaneous identification of all these conditions. We propose the possibility that hypothermia, hypoxia and hyperglycemia are beneficial for stress-exposed persons to escape from emergencies inducing stress for short periods of time, but that such internal environment might become cancer-inducing over a longer period of time.…”

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

“…Thus, the response rate has been adjusted. There is lack of robust evidence of improved response by increasing the dose in non-responders [5], although studies indicate that the response rate may be increased by up to 12% in 8 weeks [17], and up to 17% in 12 weeks [18], by doubling the dose. We have assumed that by 8 weeks (two treatment cycles), the EPO response rate is 70% to EPO single dose, and when doubling the dose for nonresponders after 4 weeks (one treatment cycle) the response rate will be 80%.…”

Effect of epoetin alfa therapy on cognitive function in anaemic patients with solid tumours undergoing chemotherapy

“…Cancer-related anaemia, a syndrome of multifactorial origin, affects a sizeable proportion of patients and gener-ates a variety of debilitating symptoms including fatigue, loss of energy, cognitive impairment and poor quality of life (QOL) (Libretto et al 2001;Iconomou et al 2003;Bokemeyer et al 2004;Heras et al 2005). It is well documented that the use of recombinant human erythropoietin (epoetin alfa -Ea) -the haematological growth factor that stimulates red blood cell production -at a dosage of 40000 units (U) once weekly or 10 000 U three times weekly successfully corrects cancer-and chemotherapyinduced anaemia and reduces the need for blood transfu-sions in a significant proportion of patients (Bamias et al 2003;Henry 2004;Desai & Demetri 2005;Bohlius et al 2006).…”