Prior red blood cell transfusions in cancer patients increase the risk of subsequent transfusions with or without recombinant human erythropoietin management.

Couture et al. perform an interesting meta-analysis of 5 previously reported, placebo-controlled epoetin alfa studies in anemic cancer patients on chemotherapy. Their conclusions are simple and intuitive: previous blood transfusion and low baseline hemoglobin predict for future blood transfusions. However, I am not sure if their suggestion that earlier treatment with epoetin alfa necessarily prevents […]

A randomized comparison of every-2-week darbepoetin alfa and weekly epoetin alfa for the treatment of chemotherapy-induced anemia in patients with breast, lung, or gynecologic cancer.

An important trial by Schwartzberg et al. has recently been published in The Oncologist. In prospective manner, this trial tested the two erythropoietin preparations commonly used in the US, epoetin alfa and darbepoetin alfa, in their most commonly used doses and schemas in anemic cancer patients on chemotherapy. The two drugs performed with remarkably similar […]

Can erythropoietin therapy improve survival?

Anemia is a significant problem for cancer patients, especially those receiving chemotherapy. Preventing or treating anemia in these patients has clear cut quality of life improvements for the patients AND their care givers. Glaspy et al. furthermore tackle the important issue of survival and venous thromboembolism in their review article. They convincingly make the case […]

Tandem high-dose therapy (HDT) for multiple myeloma: recombinant human erythropoietin therapy given between first and second HDT allows second peripheral blood stem cell transplantation without red blood cell transfusion.

This is a very interesting and noteworthy study. We know that autologous transplants can cause severe anemia, but we also know that EPO therapy does not work well in the immediate post-transplant setting. This is probably because the bone marrow graft comes from the patient himself and is therefore usually pretreated with chemotherapy and less […]

Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial.

This study by Henke et al. is certainly provocative. It reports a poor disease free and overall survival in head and neck cancer patients receiving locoregional radiation therapy. What might explain this negative tumor and overall survival effect in this erythropoietin study when virtually every other erythropoietin study has not had such an observation? First […]

Recombinant human erythropoietin, epoetin beta, in patients with relapsed lymphoma treated with aggressive sequential salvage chemotherapy – results of a randomized trial.

This positive study demonstrated that epoetin patients did better than no epoetin control patients in a relapsed lymphoma, autologous stem cell transplant setting. Epoetin has been shown not to be very effective in the high dose chemotherapy stem cell transplant setting when given only at the time of transplant and high dose chemorx. As demonstrated […]

Once-weekly epoetin beta is highly effective in treating anaemic patients with lymphoproliferative malignancy and defective endogenous erythropoietin production.

This is an important EPO trial in hematologic malignancy patients for two reasons. It demonstrates that lower EPO levels predict response… an observation not reproduced in solid tumor patients but important to remember in hematologic malignancy patients. It also demonstrates that a weekly dose of EPO, here at a 30,000 U level, is comparable to […]