CDDP-induced anemia is corrected by rHuEPO, which results in reduced blood transfusion requirements.

In 20 patients with cisplatin-associated anaemia (haemoglobin less than 90 gl-1), recombinant human erythropoietin was administered subcutaneously three times a week on an outpatient basis. The initial dose was 50 Units Kg-1 of body weight. If response was not achieved within 3 weeks, dose was increased to 75 Units Kg-1. Using the same criteria further escalation to 100 Units Kg-1 was performed. If there was no response erythropoietin was terminated. Fifteen patients obtained an increase in haemoglobin to above 100 gl-1 which was considered as a clinical response in this study, with a dose of 50 Units Kg-1; one patient needed an erythropoietin dose of 75 Units Kg-1 and one a dose of 100 Units Kg-1. Only three patients required haemotransfusions and were considered non responders. Haemoglobin increases occurred despite continuation of cisplatin chemotherapy. In conclusion subcutaneous low dose of erythropoietin seems to be effective and safe in the treatment of cisplatin-induced anaemia.

Forty-one patients with metastatic colorectal cancer were treated every four weeks with methotrexate 25 mg/m2 i.v. days 1, 8, 15; vincristine 1 mg/m2 i.v. day 1; lomustine 100 mg/m2 p.o. day 1. Inclusion criteria were: failure of previous 5-fluorouracil/leucovorin treatment; performance status (ECOG) 0-2; age less than 60 years; presence of symptoms; absence of concomitant diseases. Metastatic sites were: liver 30, lung 4, abdominal/pelvic mass 7. Three patients achieved partial responses (2 liver, 1 lung metastases); 4 showed stable disease and 34 progressed on therapy. The median survival of patients with partial response, stable disease and progression was comparable (24, 21, 22 weeks respectively). The most common toxicity was hematologic (thrombocytopenia and leukopenia). Other side effects included nausea and vomiting, stomatitis and diarrhea. Symptoms were not affected by treatment. We conclude that salvage chemotherapy is not recommended in colorectal cancer after 5-fluorouracil/leucovorin treatment even in patients with generally considered favorable characteristics for response to chemotherapy.

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