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 […]
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 […]
Effect of recombinant human erythropoietin on quality of life in cancer patients receiving chemotherapy: Results of a randomized, controlled trial.
A nice demonstration again in a placebo controlled trial that recombinant EPO is safe and effective in anemic cancer patients on chemorx. The three times weekly dose is more commonly replaced now with the once weekly dose, starting at 40,000 U SQ. – David H. Henry
Prospective current study on factors influencing need of blood transfusion in cardiac surgery. Logical results. – Volker Kretschmer
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 […]
Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study.
A nicely done placebo controlled trial of darbepoetin in anemic hematologic malignancy patients demonstrating darbepoetin’s efficacy and safety. – David H. Henry
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 […]
This article provides additional insight into the relationship between hemoglobin and birth outcome. The influence of anemia or hemoconcentration on birth outcome has been discussed for years. This study nicely shows that low hemoglobin levels (< 9.5 g/dL) but also high levels (> 12 g/dL) have a negative impact. While low hemoglobin levels are associated […]
This is a good review of tissue hypoxia and its impact on radiation response in certain solid malignancies (head and neck or cervical cancer). – Patricia Ford
The effects of epoetin alfa on transfusion requirements in head and neck cancer patients: a prospective, randomized, placebo-controlled study.
An exciting issue is studied in this head/neck cancer patient population. Perioperative EPO may have a role to decrease blood transfusion needs and speed recovery. While this is only a single institution study, it continues to make the point that this strategy can be effective. Further study is needed to see if it will have […]
Response predicting factors to recombinant human erythropoietin in cancer patients undergoing platinum-based chemotherapy.
This is a well done study of anemic cancer patients on cisplatin chemotherapy that documents nicely that the best predictor of an ultimate good response to epoetin is an early response to epoetin… in this case at 4 weeks. Sadly, we still know that about two thirds of patients respond, but we cannot predict at […]
This case control cohort study reports that the efficacy of acute normovolemic hemodilution as a blood conservation technique appears limited due to the usually poor clinical status of patients undergoing femoro-distal bypass grafts. – Philippe Van der Linden