Prediction of response to recombinant human erythropoietin (rHuEpo) in anemia of malignancy

• Published in: Haematologica (Roma) Vol. 81; no. 5; pp. 434 - 441
• Main Authors: Cazzola, M, Ponchio, L, Pedrotti, C, Farina, G, Cerani, P, Lucotti, C, Novella, A, Rovati, A, Bergamaschi, G, Beguin, Y
• Format: Journal Article Web Resource
• Language: English
• Published: Pavia Haematologica 01-09-1996; Ferrata Storti Foundation
• Subjects: Anemia - drug therapy; Anemia - etiology; Anemia/drug therapy/etiology; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Erythropoietin - therapeutic use; Hematology; Human health sciences; Humans; Hématologie; Medical sciences; Neoplasms - complications; Pharmacology. Drug treatments; Predictive Value of Tests; Recombinant Proteins - therapeutic use; Sciences de la santé humaine; Refractory anemia; Human; Immunopathology; Erythropoietin; Treatment efficiency; Cytokine; Malignant hemopathy; Hemopathy; Malignant tumor; Glycoprotein hormone; Non Hodgkin lymphoma; Myeloma; Myelodysplastic syndrome; Chemotherapy; Treatment; Immunoglobulinopathy; Lymphoproliferative syndrome; Complication; Predictive factor
• ISSN: 0390-6078; 1592-8721; 1592-8721

Department of Internal Medicine and Medical Therapy, University of Pavia Medical School, IRCCS Policlinico S. Matteo, Italy.
BACKGROUND: Since only a portion of anemic patients outside the uremia setting benefit from erythropoietin treatment, a reliable means of predicting potential responders and nonresponders would be very useful. MATERIALS AND METHODS: We retrospectively reviewed the clinical records of 58 patients with refractory anemia associated with various malignant disorders who had been treated with subcutaneous rHuEpo. The starting rHuEpo dose was 375 U/kg/week for 4 weeks, and was increased to 750 U/kg/week for another 4 weeks if no response was observed. Response was defined as a Hb increase > or = 2 g/dL with no need for blood transfusion. We examined the value of various laboratory parameters (baseline levels, 2-week and 4-week changes) as predictors of response. Endogenous erythropoietin production was evaluated by its serum level and erythroid activity was assessed through reticulocyte count and circulating transferrin receptor. RESULTS: Forty-eight individuals were evaluable, 58% of whom responded to rHuEpo within 8 weeks. Multiple regression analysis showed that 53% of the variation in the 8-week Hb concentration was explained by variations in baseline serum erythropoietin and the 2-week change in serum transferrin receptor (p