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BackgroundThe response to epoetin-alpha treatment is hard to predict in cancer patients receiving chemotherapy.MethodsOne hundred and seventeen patients were enrolled in this observational study. They had a hemoglobin (Hb) level less than or equal to 10.5 g/dL, were receiving platinum chemotherapy with three cycles pending, and they did not have an iron deficiency or hemolysis. Epoetin-alpha was administered subcutaneously three times a week at a dose of 150 IU/kg. Ninety patients were examined.ResultsResponse was defined as an increase in Hb of at least 2 g/dL during the treatment period. The response rate was 63.3%. The following data were compared between responders and nonresponders at the onset of treatment and after 2 and 4 weeks of epoetin therapy: Hb, reticulocytes, serum iron, ferritin, transferrin, transferrin saturation index, and endogenous erythropoietin levels. At baseline, these variables were similar for responders and nonresponders; after 2 weeks, responders showed higher Hb (P = 0.001) and transferrin levels (P = 0.042) and reticulocyte counts (P = 0.003); after 4 weeks, only the Hb level showed a significant difference (P < 0.0005). Changes from baseline in Hb level after 2 and 4 weeks correlated significantly (P < 0.01) with response. The change in Hb level at Week 4 was the best predictor. A change in Hb level of less than 0.5 g/dL was associated with a lack of response (predictive power, 71%); a change in Hb greater than or equal to 0.5 g/dL was associated with response (predictive power, 89%).ConclusionsResponse to epoetin-alpha treatment in cancer patients receiving platinum chemotherapy can be predicted from changes in Hb level after 4 weeks of therapy.

Original publication

DOI

10.1002/cncr.10980

Type

Journal article

Journal

Cancer

Publication Date

12/2002

Volume

95

Pages

2408 - 2413

Addresses

Hospital La Paz, Servicio de Oncología Médica, Madrid, Spain. oncopaz@ene.es

Keywords

Humans, Anemia, Cisplatin, Hemoglobins, Erythropoietin, Epoetin Alfa, Recombinant Proteins, Hematinics, Antineoplastic Agents, Prognosis, Treatment Outcome, Predictive Value of Tests, Adult, Aged, Middle Aged, Female, Male